Nerve Injuries Between the Spine and Elbow

Among the most common types of nerve entrapment is Thoracic Outlet Syndrome (TOS) causing pain and weakness in the neck, shoulder, arm and hand.

Although all physicians understand the role of spine problems in causing shoulder and arm pain, there is a great deal of controversy and confusion regarding the diagnosis of thoracic outlet syndrome. Nerve entrapment of the median nerve in the wrist at the carpal tunnel can affect the thumb and next two fingers – carpal tunnel syndrome. Entrapment of the ulnar nerve at the elbow is cubital tunnel syndrome. However between the spine and the elbow there are many nerves, crossing a long course when these nerves become entrapped or injured, the diagnosis may be TOS.

Thoracic outlet syndrome can affect the blood vessels, or the nerves or both. In the past, it has been easy to diagnose TOS affecting the blood vessels – causing loss of blood flow when the arms are raised. However, diagnostic proof of TOS affecting the nerves has been considered unsatisfactory or very difficult to achieve. Now, the advent of MR Neurography and Open MR guided injections has revolutionized diagnosis and treatment in this field.