Neural tension

Hi,

I've been having problems with pains (mostly in my hands and arms, but also in my legs and feet) and tingling (fingers and toes). I also get cold hands and feet (not Raynauds since I don't get a line of colour change or pain when they warm up). I've seen two different physios (private and now NHS) who think that my upper limb symptoms are due to neural tension and have given me various exercises which haven't really made much difference.

The pains are sometimes sharp, sometimes dull and achy, and are mostly in the hands, inner forearm and elbow and seem to be due to the ulnar and median nerves (though the ulnar nerve regions are worse). This all started in December and I've had some tests by my doctor - blood tests, checked responses, pulses - which are all okay.

The exercises I've been given involve lots of neck stretches (which have definitely loosened up my neck which has been stiff), twisting upper body from side to side, and very gentle nerve mobilisation exercises. The latter have had to be drastically cut down from the original plan because they were making the pain worse. I've been doing them for several weeks but with no improvement. My physio is rather stumped and says he has never seen this amount of neural tension before. He is getting me to see a colleague who has more experience with this. Does anyone have any ideas which might help?

Also, I'm wondering whether this is due to my desk set up at work (I couldn't get my chair close to the desk so was typing with my arms quite far in front of me). I've now got a new chair and lots of gadgets - arm rests (the health and safety advisor at work says I should have something to rest my arms on), wrist rests, alternative mouse etc. I've been trying these out, but am not really sure what position I should be aiming at. Could you please give me some advice on posture to avoid making my problems worse?

Thank you

If you are already set up to see a more experienced physio then the importance of correct working posture should be brought into the physio treatment ASAP when you see him/her. Bad ergonomics would/could aggravate symptoms. I would hope now that the new physio would reassess you and having you in front of him, as it were, as opposed to online, will enable a much more accurate correction of your posture. They need to come up with a good hypothesis as to why you have neural tension, and a good "manual therapy" and neural assessment, in order to avoid irritating the problem again. You can keep us posted as to what comes up
Regards JM

Thanks for the reply. I agree that that would be the ideal situation, but unfortunately I'm not seeing her for 2 weeks. Any pointers in the meantime would be very gratefully received - for instance, should I be using arm rests or not?

Most of the online ergonomic stuff I have is in german but I just googled with ergonomics+workplace and found this link:
Ergonomics of the Office and Workplace: An Overview
which has information including diagramm of sitting posture at work. It's not just what equipment you have but how you use it and the correct heights etc for your body. There seemed to be lots to look at to get you started. Must look at it myself again.