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The Domino Effect: How Your Neck's Rebellion Leads to Shoulder, Elbow, and Wrist Pain


Typically when we experience wrist, elbow, or shoulder pain we assume the issue is in that area. However, the neck can be the root cause of all this pain. The cervical spine is a delicate tower of vertebrae tasked to support the heavy head through all of life's twists and turns. If this feat is too great for the cervical spine to manage, it demands extra work from the neck muscles specifically the scalenes and the sternocleidomastoid (SCM). These scalene muscles attach to the first rib...yes the ribs go all the way up to the neck. The cervical spine, 1st rib, and scalene muscles make a triangle on each side of the neck. This may sound like a lot going on in a small area but wait, there's more to this triangle of terror. All of the arteries and nerves that supply the arm run through this triangle. When these muscles get tight, it elevates the first rib, which compresses the arteries and nerves, and Voila! We get a mess of misunderstood pain and symptoms.


This compression can lead to a condition known as Thoracic Outlet Syndrome (TOS), characterized by symptoms such as shoulder pain, numbness or tingling in the arm or hand, and weakness. But the drama doesn't stop there. The effects of tight neck muscles and the elevated first rib can ripple down the arm, wreaking havoc on the shoulder, elbow, and wrist joints. Because TOS can cause pain and symptoms in several places, it can be difficult to identify the actual cause of pain leading to misdiagnosis. Symptoms of TOS can include shoulder pain with overhead movements, difficulty reaching behind the back, and general shoulder weakness mimicking a rotator cuff injury or bursitis. Additionally, symptoms of tennis or golfer's elbow (tenderness and pain around the elbow) could be due to TOS. Finally, these tight neck muscles can lead to carpal tunnel syndrome or symptoms of tendonitis.


So what can be done if you experience any of this musculoskeletal misery? The first step is to identify the actual cause of your pain as your pain may be just the tip of the iceberg. Once the root cause is sniffed out, then the issue can be addressed through gentle stretching, strengthening, and movement re-training. The act of posture and movement re-training is important to help prevent the reoccurrence of muscle tightness. So the next time you experience shoulder, elbow, or wrist pain, look to the neck for the whole story.


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