Trigger point therapy by a licensed massage therapist who is skilled in neuromuscular therapy (trigger point therapy). Read the "sticky note" explanation of trigger points on the main page.

The brachial plexus (BP) is often compressed by the scalenes in the lateral neck (three on each side, and each can have 2-3 active trigger points). Farther down the line, the BP can be compressed by the pectoralis minor, which attaches to the coracoid process of the scapula (located beneath the clavicle). Next trouble spot for the BP is deep in the armpit, where it passes beneath the coracobrachialis, which also attaches to the coracoid process of scapula. In the posterior elbow region nerves are close to the surface and easily damaged there, but for the same reason unlikely to be compressed down here. But further down, as the nerves and blood vessels move into the hand, the retinaculum of the hand can compress the heck out of one or more tendons, blood vessels and the median nerve-- the infamous carpal tunnel. Carpal tunnel syndrome is often confused with TOS compression of the entire brachial plexus. As a rule, if the pain/tingling is felt in the thumb and first two fingers, it's probably cPS; felt in the others, it's probably TOS compression higher up.

MT for TrPs is slightly painful. If you visited the sticky notes I directed you to, you know that a TrP can cause the entire muscle to become hypertense, which limits circulation through it, which causes ischemia which causes sensory nerves to light up. But by definition an active TrP can send its pain to another muscle-- i.e., a scalene TrP can send pain into the fingertips or-- oddly!-- into the infraspinatus or other muscle that either attaches or is very close to the scapula. TrP work is slightly painful, but releasing the several TrPs in the muscles that can compress the BP will take just a few minutes, and the pain relief will be evident before you leave the MT's office.

PT can be effective treatment for TOS. But in my personal opinion, MT is quicker, more likely to bring relief, and it is certainly less costly. Medical doctors' standard treatment of trigger points is an injection that calms the trp temporarily along with a cortisone shot into the affected joint. The opinion of at least one clinical study is that cortisone has an adverse affect on tendons, ligaments and muscle tissue itself. (google "cortisone--is it really good").

Do read the sticky note: it is first rate explanation of trigger points.