Cervical Spine Herniated Disc
Individuals with a cervical disc pathology will most likely have constant pain in the neck and shoulder region and it will follow a radial distribution; whereas with TOS the pain is intermittent. If numbness does occur, it will follow a radial nerve distribution down the arm and into the 1st and 2nd digits. However, TOS numbness normally occurs in an ulnar nerve pattern (4th and 5th digits) or down the whole arm. Aggravating factors for the cervical disc pathology may include rotation and lateral flexion of the head and compression of the head onto the cervical vertebrae. In contrast, TOS symptoms are aggravated with arm elevation and compression of the brachial plexus.
Signs in common with thoracic outlet syndrome
(Brantigan, 2004 & Watson et. al., 2009)
Signs in common with thoracic outlet syndrome
- Pain in the cervical spine, radiating into the upper extremity and medial scapula
- Pain aggravated by cervical movements rather than arm motion
- An easing factor can be arm elevation, but this is an aggravating position for TOS
- Cervical range of motion
- Neurological examination (hyporeflexia in severe disc pathologies)
- Cervical compression and distraction tests
- Spurling’s maneuver
- MRI
(Brantigan, 2004 & Watson et. al., 2009)