Video Transcript: Treat Brachial Plexus Nerve Pain with the First Rib Muscle Energy Technique (MET)

Transcript: Hi guys, Doctor Orit Hickman here and I'm going to show you a really simple technique that we use for a lot of different types of pain.

Most common is neck pain on the same side where patients will complain of it hurts to side-bend to one side. It might hurt to bring the head up and look up at the ceiling on that side. There might be shoulder pain that radiates from the top of the shoulder, down into the shoulder blade, up into the neck, and sometimes even to the pec muscle. Rarely will it travel down the arm, but occasionally you can have symptoms that travel down the arm.

Most common cause for this is tightness of the neck muscles in the front called your scalenes(1), and your scalenes attached from your first and second rib and they come up to attach into the side of the neck. And when those muscles get tight, they pull up on that first rib a little bit, so it irritates the neck. But, it can also irritate the nerves that travel down into the arm, which is why pain can sometimes radiate down to the arm.

So, there's a really simple technique that you can use to try to calm those muscles down.

And so what you would do is you're just going to take your opposite hand. So, I'm going to do this for my right side. So, let's say it hurts for me to side-bend my head to the right side for me to look up at the ceiling. And I might try to do this. This is called a First Rib Muscle Energy Technique.

So, what I'm going to do is I'm going to put pressure right here on the muscles on the front, and they might be pretty tight and even a little bit sore. And I'm then going to take my hand on that right side, and I'm gently going to push the palm of my hand into my head as if my head was going to do this motion and I'm trying to stop it.

So, what I'm going to do now is I'm gently going to push down with my left hand and I'm going to push into the head with the right hand. And I'm going to push in and I'm going to hold, 2, 3, 4, 5. I'm going to relax.

I'm going to try to side-bend my head a little bit further and as far as I can go comfortably. I'm going to push again. I'm going to push down and push in and hold, 2, 3, 4, 5. And then I'm going to relax.

And I'm going to do that one more time, if I can. I'm going to push, 2, 3, 4, 5. And then I'm going to relax.

I'm going to keep the pressure with my left hand down on the muscle and then I'm going to let go. And what I’m going to do after that is I’m going to recheck. I'm going to see how it feels to go to the side bending, and see how it feels to go up and look at the ceiling, maybe even go to the opposite side and see if it feels a little bit looser. It should feel less pain for going to the side that hurt originally. Give that a try.

Definitely if you're working with a physical therapist, check with them first, but let us know how it goes.

Take care!

1) https://teachmeanatomy.info/neck/muscles/scalene/