Scalene syndrome is one of the conditions that causes pain, numbness, and tingling down the arm and hand. When the scalene muscles go into spasm they can entrap or compress nerves and arteries. The nerves and arteries travel in between the scalenes muscles as they leave the neck that travel down the arm.
There are several small scalene muscles in the front of the neck. They help control normal neck flexion movements. They play an important role in the neck curvature and fine motor control movements of the cervical spine. Commonly when people have poor postures working at a computer or desk they develop spasms in these muscles. Trigger points can produce radiating pain from the scalene muscles down into the arm. In addition the muscles are commonly aggravating tension and migraine headaches.
When the muscles go into spasm they produce a compression force on the artery as it leaves the neck and travels toward the shoulder.
When the scalene muscles are can pressing the artery people describe their hand as “going to sleep.” They feel tingling with certain postures or activities. They often wake up in the morning or the middle the night with a numb hand. Their first thought is often carpal tunnel. However carpal tunnel affects the thumb and two fingers next to it. Scalene syndrome and any thoracic outlet syndrome will affect the whole hand.
People find relief either moving their shoulder or neck, as these two movements reduce the compression on the artery. Scalene syndrome fluctuates over time. People can have mild to moderate symptoms for months that slowly increase over time. It usually does not inhibit them from their normal activities, it is mostly described as bothersome in the early stages. As it develops to moderate or severe levels people begin to avoid activities with their hand in front or above their head. Their sleep becomes disrupted.
Treatment involves decreasing the muscle spasms and hypertonicity of the scalene muscles. Often massage therapy is an excellent treatment at reducing the spasms, pain, and tenderness of the scalene muscles. Graston Technique is a another soft tissue technique that is excellent at decreasing scar tissue and muscle spasms. It can be used over the neck muscles and shoulder.
Often when people develop scalene syndrome they show signs of upper back and neck dysfunction; such as trapezius and pectoralis muscle spasms and decrease flexibility in these muscle groups. Treatment also works at decreasing the flexibility of these muscles and improving posture, to decrease stress and strain on all of the involved neck and back muscles.
Physical therapy works to enhance flexibility, strength, and endurance of appropriate muscles. Electric therapy can often be used to enhance physical therapy stretches to produce faster results.
We see excellent results at treating scalene and thoracic outlet syndromes with our therapeutic treatments and providers. A combination therapy of physical therapy and massage therapy produces excellent results.