Paul Manley Back Pain and RSI Clinic

Paul Manley, D.O. (ESO 1980), M.A.O.(Manip), Registered Osteomyologist
For muscle and joint problems

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Paul Manley, D.O. (ESO 1980), M.A.O.(Manip),
Registered Osteomyologist, RSM
(Royal Society of Medicine)
Specialist in the treatment of Musculo-skeletal problems

Location: 33 Chalton St, London NW1 1JD (Close to Kings Cross and Euston stations)

RSI trigger areas : Neural

What is RSI?>> RSI muscle triggers>> RSI nerve triggers>> RSI pathophysiology>> RSI treatment

If there is a tendency for nerve compression, especially involving the Median nerve, there are specific points where nerve compression can occur, They are as follows:

  • Lower cervical lesions- can affect any nerve, Radial, Ulnar but principally the Median nerve. Symptoms of pain (Radial nerve) and numbness in hands. The Ulnar nerve will produce pins and needles and numbness of the outside of the hand, little and ring fingers and side of palm. Such lesions when severe produce symptoms which are constant

  • 1st, 2nd and 3rd rib lesions- elevates and compresses the Brachial plexus. Principally affects the Median nerve. Not usually painful producing pins and needles and occasional numbness in the palm side of the thumb, index fingertip, middle fingertip and sometimes the tip of the ring finger
  • Brachialis in the 'crook of the elbow' can further compress the Median nerve. A sign of Brachialis hypertonus is an inability or difficulty in straightening the arm at the elbow. This gives the three finger tip pattern of Median nerve symptoms

  • Palmaris Longus when hypertonic pulls its fanlike attachments to the palm in will induce Median nerve compression, often in only the index and middle fingers
  • The thumb muscles will produce compression principally of the Median nerve supply to the thumb

  • The tendons and muscles of the index finger and thumb which produce 'pincer' type movements, when hypertonic, make numbness in the thumb and index fingers more likely

The thing to realise with trigger areas is that every point of compression you have adds to the tendency to produce both musculo-skeletal pain and pins and needles/numbness. It works like an 'amplifying' process. Each sections' tension pattern adding to its neighbours' along the same nerve pathway. It is a process of attenuation of the nerve signaling, whereby the entire nerve becomes more excitable, thus making subliminal pain spring into consciousness manifesting as a symptom. This overall excitability affects the excitibility of the reflexes and thereby the tone of the muscles involved in the highest activity rate rises and tension mounts. You know how it is when someone presses your shoulders and finds places of tension that you didn't realise were there. These areas of hypertonicity are generally not needed by the body, unless you are a lumberjack!! The point being that we are all on the verge of  being in pain all the time in many places of our body its just that our nervous system cleverly 'damps' it down so that we don't suffer too much.


What is RSI?>> RSI muscle triggers>> RSI nerve triggers>> RSI pathophysiology>> RSI treatment


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Please Call or Text Paul 24/7 on 07925 616 753
London location: 33 Chalton St, London NW1 1JD (Close to Kings Cross and Euston stations)

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