Question
First and foremost - thank you for reading this. About a week ago, I returned from work and had right arm paresthesia that occurred only after I finished a 10hr shift and was sitting on the couch relaxing.  The next day that went away but my right arm felt heavy, more cold, and muscles weren't contracting as fast as my left arm. It reminded me of thoracic outlet since I had that two years ago after a car accident (due to scalene and upper trap spasm).  A general doctor and a friend (P.T.) looked at me and said strength, pulses, and reflexes were fine - despite the arm still feeling weaker than the right.  They also said that stress is re-causing my previous TOS.  After a couple of days, strength was normalizing but I started having localized "aching" throughout the arm. If I slouch a little its in the posterior shoulder. If a sit upright with scapula back then that disappears but I feel it more in the distal tricep area. Occasionally I get it in the lateral elbow but I know its not tennis elbow.  

I know this isn't as bad as other conditions, but I want to know what could possible cause it.  It just came out of the blue one day. I have been stressed from work but I've been in more stressful situations before. I don't exercise as much as I should. Don't eat well or drink enough water. Posture is like a normal human being - rounded shoulders, forward head. My sleeping posture isn't the greatest - sleep on 2+ pillows, on my stomach or sides, rarely on my back. My friend (P.T.) was able to reproduced some of the symptoms with palpating the neck and providing some traction on the neck.  He's saying its coming from the neck not so much TOS.  I don't really feel "tension" per se in my neck.

I was in a car accident two years ago- but after the muscle spasm diminished all symptoms went away and I felt normal. I've also had a blow to the face 2.5 yrs ago and despite hairline fractures I was okay as well.

Is it possible to be a pinched nerve?  The general doctor gave me a referral to see a neurologist at this end of this month.  My symptoms are not life-threatening at all but my career relies on my arms and this is annoying.

Answer
There are many possibilities of what could be causing your discomfort, and without examining you myself, i am just speculating.  All of the habits you mentioned, sleeping, stress, posture, could be causing the symptoms.  There could be some bony misalignment in the cervical spine or even upper thoracic spine.  There could be some deeper muscle involvement from the trauma 2 years ago, muscle has memory and it will respond to the slightest abnormality.  My strongest suggestion would be to seek chiropractic care.  I know I'm biased, but I have work in the medical field as well, and all the experiences I have witnessed, chiropractic is your best bet.  We can treat most everything that you are experiencing, and give you proper exercises to assist the corrections we make.  If you are interested in seeking chiropractic help, go to www.sorsi.com to locate a doctor near you.  I am a member of this group and would trust any of them with my own family.  I am in Minnesota in the Twin Cities and would be more than happy to see you.  If you have any other questions or concerns, please email me.

Dr. Starbuck