Scalenus syndrome is caused by muscle growth in the neck, putting pressure on nerves and arteries. It is a form of thoracic outlet syndrome and can cause pain, numbness, and weakness in the arm. Diagnosis can be complicated, and treatment options include physical therapy, medication, and surgery.
Scalenus syndrome is compression of the structures around the neck due to muscle growth. This condition is associated with the scalene muscles in the neck, which can widen and put pressure on a bundle of nerves called the brachial plexus or subclavian artery. Diagnosing this condition can be complicated and is the subject of some controversy in the medical community. Treatment options are available for patients with nerve pain, stiffness, and other symptoms caused by scalenus syndrome.
This condition is a form of thoracic outlet syndrome, in which the lesions cause problems with the brachial plexus or subclavian artery. Doctors divide this thoracic outlet syndrome into a number of subtypes on the basis of which lesions and anatomical structures are involved. In the case of scalenus syndrome, the scalene muscles are to blame. Muscle enlargement may be palpable during an exam and may also be visible on medical imaging studies. Images may also reveal signs of compression.
Symptoms can occur in athletes and other people who engage in repetitive movements that involve raising their arms. Supermarket checkers, for example, may develop thickened neck muscles because they repeatedly lift their arms to pass products across the counter. Other forms of thoracic outlet syndrome may be associated with neck injuries, such as whiplash from traffic accidents, or failure to use ergonomic postures in the workplace. Patients who sit or stand awkwardly may begin to develop uneven muscle growth, pain, and soreness, which can ultimately lead to chronic health problems.
Patients with this syndrome may develop symptoms such as pain and numbness in the arm, along with tingling sensations. Weakness may also occur, as the brachial plexus controls a number of key muscles, and damaged nerves may fail to control the arm adequately. Neck and shoulder pain and tenderness may also occur. If the patient’s subclavian artery is involved, symptoms such as an irregular pulse may be observed.
A doctor can examine a patient with these symptoms to learn more about the patient’s condition and determine whether scalenus syndrome may be responsible. One diagnostic option is a check for Adson’s sign, a loss of radial pulse in the arm when the patient inhales with the arm outstretched and the head turned in the same direction. Some people experience this clinical sign without the presence of scalenus syndrome, making it important for the patient to get a thorough evaluation. This can include imaging and an exam.
Treatment options can start conservatively with some stretches and physical therapy. Some patients benefit from medications and coaching in ergonomic positioning to prevent future injuries. Surgery may be an option in extreme cases that are unresponsive to other treatments.
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