. . .

. Individuals whose minimal symptoms (numbness, tingling, and aching pain) resolve with rest will continue to push past their not-so-obvious limitations due to previous commitments and a drive to progress in their careers, which leads to an increase in pain and sensitivity with eventual serious disability. The first step is to obtain appropriate physical therapy with an individual who has significant expertise in this disorder. I usually recommend Peter Edgelow (510.732.7881), www.edgelow.com, who has developed a technique that is effective. I encourage you to find someone with expertise in and knowledge of the techniques so ably described by David Butler in his “Mobilization of the Nervous System” and “The Sensitive Nervous System". If your physical therapist asks you to perform exercises that increase your symptoms consistently, find another one. Pharmaceuticals, unfortunately, are of minimal-to-moderate help. When appropriate, diazepam (more so than its congeners) helps in reducing the irritability and attendant trapezial and scalene muscle spasm. Other muscle relaxants, such as Flexoril or Soma, can be of benefit as well. Opiates are usually of minimal benefit and have obvious problems in select individuals. Antiepileptics and vasoactive agents play an even lesser role but can often be effective, again in select individuals.