I'm a 34 year old male. I'm an office/desk worker and until 2 months ago very active physically via resistance exercise, cycling and climbing.

I've been diagnosed by a Neurologist with bilateral vascular and neurogenic thoracic outlet syndrome, combined with bilateral ulnar nerve entrapment, which I believe can also be described as double crush syndrome.

The diagnosis was made on the basis of:

# My description of symptoms
# Physical exam by a manual physical therapist and neurologist
# Electromyography and Nerve Conduction Velocity exams
# MRI of my upper back/neck/shoulders
# Ultrasound to measure arterial blood flow upon abduction of the arms
# X-Ray to look for cervical rib or other abnormality

My first symptom, which lasted for 2 months before I sought help, was awakening from sleep with numbness present in left and/or right hand 4th and 5th digits. That was my one and only symptom for 3 months. After 3 months, and to the present day, my main complaint is that within 30-45 minutes of sitting/standing/walking with my head and neck unsupported, I develop pain in the rear neck area, which sometimes spreads to my trapezius and shoulders. I have less serious and frequent pain in my ulnar nerve around the elbow and forearm.

I'm currently undergoing physical therapy with a physio using the Barral system (a french physio)