Thoracic Outlet Syndrome, Cervical Osteoarthritis and Cervical Spondylosis

This website was developed after its founder was diagnosed with Cervical Osteoarthritis. He continues to work effectively. Read his article on how he works with Cervical Osteoarthritis

What are… Thoracic Outlet Syndrome, Cervical Osteoarthritis and Cervical Spondylosis?

These are quite different conditions but computer users with these conditions will show similar symptoms in the first instance:-

  • arm or hand – pain, numbness or paraesthesia (pins and needles)
  • shoulder pain

Vertebrae discs and nervesThey share similar symptoms because in all three cases the nerves to the upper limbs are injured to some degree by trapping.

Between each of the vertebrae in the spine is a disc with a tough outer layer of cartilage and a soft gel inner. The discs provide flexibility in the spin and also absorb the shocks that the spine takes in normal daily life. The vertebrae extends into the base of the skull of course and that area can be where damage occurs for computer users.

The cervical spine is just another term for the neck part of the spine.

The thoracic spine is at the top of the back.

Nerves and blood vessels that go into the arm and hand start near the top of the cervical spine. Nerves come out of the spine through small openings along the side of each vertebrae. Nerves and blood vessels travel between muscles in the neck and over the top of the rib cage.

Diagnosis of these conditions requires tests carried out by specialist professionals to arrive at a diagnosis. This may involve MRI scans and/or nerve conduction tests or tests that are more specific to one condition to attempt to differentiate whether you have one condition or another. Read about our founders diagnosis of Cervical Osteoarthritis which describes MRI and Nerve Conduction tests.

Thoracic Outlet Syndrome (TOS)

Thoracic Outlet Syndrome diagnosisAn article by Benjamin M Sucher covers the condition in great detail and demonstrates diagnosis procedures – see diagram to the right.

The primary cause of Thoracic Outlet Syndrome (TOS) is considered to be poor body alignment due to slouching which over time has compressed the nerves and arteries near the thoracic outlet.

Treatment for Thoracic Outlet Syndrome

Deep heat and stretching exercises are the preferred conservative forms of treatment. However, do not be tempted to have physiotherapy without first gaining a professional diagnosis. Adson tests, such as in the diagram above, and/or Wright tests, which check pulse in the wrist whilst raising the arm are specific tests for TOS and are quickly carried out by a professional.

Keeping the neck warm in the colder months with a scarf or neck warmer is essential. Cold weather is not a problem in itself but our body usually unconsciously tenses up muscles and it is this muscle tightening which traps nerves in the neck and collar bone area.

For computer users, it is essential to reduce the potential RSI dangers through using appropriate tools.

Cervical Osteoarthritis

Cervical Osteoarthritis has the potential of trapping of nerves causing similar symptoms and again is considered to be typically caused (in this context) through long term poor body posture.

MRI is the better means of diagnosis but some symptom indicators of Cervical Osteoarthritis caused through computer use may be that you feel arm/hand pain when you look up (eg. look at the ceiling for 30 seconds).

xray of our founder showing Cervical OsteoarthritisThe source of this injury is in the neck where long term tension in the neck has caused narrowing of discs and erosion of vertebrae in the neck, this leads to a degree of collapse between discs and increases wear and tear. In effect the vertebrae in the neck have become aged before their time and Cervical Osteoarthritis is primarily erosion of the vertebrae surfaces themselves. Our founders neck MRI scan is to the right…

The nerves that supply the hand and arm can then be trapped by this erosion and collapse and that trapping will be exacerbated by muscular tension such as happens when you use a computer keyboard, mouse and screen.

Conservative treatments are the usual course of action although where symptoms become very difficult for the patient, surgery is usually an option where more more space is created for the nerves and some vertebrae are fused together to restrict movement.

Symptoms can also include stiffness and pain in the neck around the base of the skull – particularly after a period of being in one position (after sleeping or a long journey).

Treatment for Cervical Osteoarthritis

This condition is sadly chronic and treatment is usually conservative based around protecting the neck, perhaps with physiotherapy, and removing or reducing aggravating activities.

Keeping the neck warm in the colder months with a scarf or neck warmer is essential. Cold weather is not a problem in itself but our body usually unconsciously tenses up muscles and it is this muscle tightening which puts further pressure on the damaged area.

For computer users, it is essential to reduce the potential RSI dangers through using appropriate tools.

Cervical Spondylosis

Cervical Spondylosis is a similar condition to Cervical Osteoarthritis as seen from the sufferer although not medically.

The vertebrae often develop rough areas of bone called osteophytes and where prominent they will interfere with the nerves travelling through the spine. So it is a similar physical scenario but the central core of nerves in the spine are being trapped rather than their exit to limbs and organs.

It is a chronic condition which is essentially advanced ageing and degeneration of the cervical spine. Conservative treatments are the usual course of action although where symptoms become extremely difficult for the patient, surgery is usually an option where more more space is created for the nerves and some of the vertebrae are fused together to prevent movement.

The symptoms can be very similar to the above and although the condition is chronic, symptoms can have acute flare-ups and also include some wider affects such as:-

  • headache extending from the base of the skull over the top of the head
  • more rarely, weakness or problems with walking or bladder function

Treatment for Cervical Spondylosis

This condition, like osteoarthritis, is also chronic and treatment is usually conservative based around protecting the neck, perhaps with physiotherapy, and removing or reducing aggravating activities.

Keeping the neck warm in the colder months with a scarf or neck warmer is essential. Cold weather is not a problem in itself but our body usually unconsciously tenses up muscles and it is this muscle tightening which puts further pressure on the damaged area.

For computer users, it is essential to reduce the potential RSI dangers through using appropriate tools.

Computer users with computer posture problems

Poor posture at the computer, over a long period, is often the source of these conditions, for example:-
Workstation ergonomics - good and bad posturesCervical spine orientation
Imagine what happens to the cervical spine (neck bones) when in a slouching position for hours at a PC!

The spine is forced back on itself and when held in this position for long periods of time, frequently over years can result in accelerated wear and tear damage – reduction in disc height, spurs on the bone surfaces etc. This can trap nerves and cause pain.

Your checklist

  1. Good PC PostureMaintain good posture – check these items:-
    • Adjustable height seat
    • Lumber support
    • Screen at arms length
    • Top of screen no higher than your eyes
    • Wrists should be in line with your forearm and hand, not at an angle, when using keyboard and mouse
    • Upper arm should be by your side and your inner elbow should be just about touching your side. Your forearm should be near horizontal and directly in front of your side. Numeric and function keypads on keyboards make this difficult to achieve and the tensed twisted arm posture is a major cause of RSI conditions and places a great deal of strain and tension at the neck.
      This is why we strongly recommend a vertical ergonomic mouse and compact ergonomic keyboard
  2. Thankfully highly effective software to monitor your posture exists using a webcam to spot when your posture ‘goes off’
  3. Keep moving and don’t maintain any fixed posture for long periods. You need to move your body around a bit. Physiotherapists suggest, humorously, that a seat with upturned pins on it is ideal…ensuring you didn’t sit there for long!
  4. Do you regularly use a shoulder bag, carry a work bag or briefcase in one hand? If so, this is a potential hazard in creating an imbalance in your shoulder (and chest/back muscles). A backpack bag can be better in creating more balance between the arms but can also add to impingement of tendons and nerves. A pull-along laptop/office bag, is often a much better solution because so much of the weight is transferred to the floor.
  5. Other tools and aids relevant to computer posture RSI conditions generally are below. :

Ergonomic Mouse & Keyboard Buying Guide

UK Suppliers UK Suppliers

Link to UK multiple purchase and B2B supplier

Note for Evoluent mice size see sizing tab above

  • DXT Ergonomic Precision Mouse - Wired

    DXT02 Ergonomic Mouse

    Less expensive, wired version. Easy to use, hold like a pen. Ambidextrous – for left/right-handed.

    View UK Supplier
  • DXT02W-ergonomic-vertical-wireless-mouse

    DXT02W Ergonomic Mouse

    Excellent! Easy to use, hold like a pen. Ambidextrous – for left/right-handed.

    View UK Supplier
  • evoluent-vertical-mouse-profile

    Evoluent Vertical Mouse L/H-Normal

    Left-handed normal-size version (consider DXT02 instead if you have small hands)

    View UK Supplier
  • evoluent-vertical-mouse-profile

    Evoluent Vertical Mouse R/H-Normal

    Right-handed version (their normal size is for larger hands)

    View UK Supplier
  • evoluent-vertical-mouse-profile

    Evoluent Vertical Mouse R/H-Small

    Right-handed small-hand version (normal size is for large hands)

    View UK Supplier
  • perixx-407

    Perixx Mini Keyboard

    Slim compact keyboard. Integrated numeric keypad with Num Lock.

    View UK supplier
  • saturnus-mini-keyboard

    Sboard Mini Keyboard

    Slim compact keyboard. Integrated numeric keypad with Num Lock

    View UK supplier
  • Anker 2.4G Wireless Vertical Ergonomic Optical Mouse

    Wireless Ergonomic Optical Mouse from Anker

    Not ideal. Better than ‘normal’ mouse. Only suitable for larger hands

    View UK Supplier
  • Perixx-wireless-ergonomic-optical-mouse

    Wireless Ergonomic Optical Mouse from Perixx

    Not ideal. Better than ‘normal’ mouse. Only suitable for larger hands

    View UK Supplier

USA Suppliers USA Supplier

Note for Evoluent mice size see sizing tab above

  • DXT02W-ergonomic-vertical-wireless-mouse

    DXT02W Ergonomic Mouse

    Excellent! Easy to use, hold like a pen. Ambidextrous – for left/right-handed.

    View USA Supplier
  • evoluent-vertical-mouse-profile

    Evoluent Vertical Mouse

    Select from left-hand, right-hand, small-hand, wired and wireless options

    View USA Supplier
  • perixx-407

    Perixx Mini Keyboard

    Slim compact keyboard. Integrated numeric keypad with Num Lock.

    View USA supplier
  • saturnus-mini-keyboard

    Sboard Mini Keyboard

    Slim compact keyboard. Integrated numeric keypad with Num Lock

    View USA supplier

Canadian Suppliers Canadian Supplier

Note for Evoluent mice size see sizing tab above

  • DXT02W-ergonomic-vertical-wireless-mouse

    DXT02W Ergonomic Mouse

    Excellent! Easy to use, hold like a pen. Ambidextrous – for left/right-handed.

    View Canadian Supplier
  • evoluent-vertical-mouse-profile

    Evoluent Vertical Mouse

    Select from left-hand, right-hand, small-hand, wired and wireless options

    View Canadian Supplier
  • perixx-407

    Perixx Mini Keyboard

    Slim compact keyboard. Integrated numeric keypad with Num Lock

    View Canadian Supplier
  • saturnus-mini-keyboard

    Sboard Mini Keyboard

    Slim compact keyboard. Integrated numeric keypad with Num Lock

    View Canadian Supplier

The Evoluent VerticalMouse 4 regular size models which are sometimes called 'large' (Right Wireless, Right Mac, Right Bluetooth, Right and Left) are for hands at least about 7 inches or 178 mm from the tip of the middle finger to the wrist crease. Hands shorter than 7 inches/178 mm may be more suitable for the VerticalMouse 4 Small.

Evoluent mice sizing guide