In clinical practice, we often see patients with numbness in one of their upper limbs, and the first thing they think of is whether there is a problem with the cervical spine. It is true that nerve compression in the cervical spine can cause numbness in the arms and hands, but is it necessarily cervical spondylosis if there is numbness in the upper limbs? We say that clinically it is not that simple. The nerve path of the upper extremity is relatively long, and any problem in this path may cause numbness and pain in the upper extremity, and cervical spine problems are not the only cause. Now let’s dissect the problem of nerve compression in the upper extremity. Where do the nerves in a person’s arms come from? There should be no problem with the general public’s scientific understanding that the nerves in the arms mainly originate from the cervical spine. But one thing needs to be clarified, not all the nerves emanating from the cervical spine come to the arm, and not all the nerves in the human arm emanate from the cervical spine. So first of all, we need to give a brief, scientific introduction to the anatomy of the upper extremity nerves, also called the brachial plexus. We all know that there are seven cervical vertebrae in the human body, and from these seven cervical vertebrae there are seven pairs of crestal nerves, that is, seven pairs of nerves in the cervical spine. These seven pairs of nerves, the first to the fourth pair, do not go to the upper extremities, the first to the fourth cervical nerves are mainly distributed to the back of the neck and head, that is, the occipital region, so these four pairs of nerves are not involved in the composition of the brachial plexus. The fifth, sixth and seventh pairs of nerves of the cervical spine, as well as the upper thoracic spine (first and second pairs) constitute the brachial plexus, and these nerves go to the upper extremities of the person. So we need to know that problems in the upper extremities are related to the lower nerves of the cervical spine, not to all of the cervical nerves. So, how do the nerves in the lower cervical spine reach the human hand after they originate from the cervical spine? First of all, the nerves have to come out from the small holes on both sides of the cervical spine, which are called intervertebral foramina, to form the cervical plexus, anatomically called the cervical plexus. After the cervical plexus is formed, it first passes through the axilla, or the human armpit, and continues to the upper extremities. The nerves in the axilla and below the axilla are called the brachial plexus. The brachial plexus travels around the arteries and veins of the axilla, through the axillary fossa, and then further down along the upper arm. The next link goes through the elbow of the body, forming further branches that travel up the forearm, our little arm. After the nerve passes through the small arm, the next link is the wrist of the body. After the nerve passes through the wrist, it then forms a finer, more specific branch that continues to the end of the upper extremity, which is the tip of the finger. Therefore, we say that the brachial plexus nerve originates from the cervical spine, passes through the axilla, elbow, wrist and finally reaches the fingers. From the introduction of the anatomy of the brachial plexus nerve, we can see that the nerves of the upper extremity have to pass through several gates in the process of travel, firstly, the cervical spine, the intervertebral foramen, the axilla, the elbow and the wrist. It is through these gates that the distal limbs, that is, the fingers, are reached. If there is a problem at these gates, the nerve compression can cause symptoms in the upper limbs, such as soreness and numbness, and even weakness and muscle atrophy are all possible. So here we can be clear, not the symptoms of the upper extremities must be caused by cervical spine problems. Now let’s go from top to bottom to sort out several gates in the process of nerve travel in the upper extremities, to see what problems can occur in the upper extremities of numbness symptoms. First of all, the cervical spine, cervical nerve roots in the intervertebral foramen, if there is an osteophyte in the intervertebral foramen, compression of the nerve to produce edema, is sure to appear symptoms. If there is soft tissue hyperplasia, neoplasia, or inflammation of blood vessels, inflammation of fascia, or inflammation of ligaments in the axillary area, causing edema and compression of the nerve, symptoms of numbness in the distal part of the limb, that is, the arm or hand, can also occur. The next link to the human body is the elbow, which has an anatomical structure called the elbow canal, a relatively narrow bony canal formed mainly by bones and ligaments. When the nerve comes out of the elbow canal, if there is a problem in this area, such as osteophytes and hypertrophy of the ligamentous ligaments, compression of the nerve will also cause symptoms in the upper extremity. Let’s look at the carpal tunnel. One of my previous scientific articles detailed the problems of carpal tunnel syndrome. The carpal tunnel is more likely to be affected by strain factors because we use our wrists every day, whether it’s tapping on a keyboard, riding a bicycle handlebar, or using a mouse, all of which can cause strain on the carpal tunnel. After the carpal tunnel compresses the nerve, the symptoms may be more obvious, and the distal fingers may have severe soreness, numbness, swelling or weakness and muscle atrophy. Therefore, in addition to the cervical spine, once the numbness of the upper extremities occurs, we should also think of the axillae, elbows and wrists as possible causes of the problem. Acupuncture is very effective for a wide range of peripheral nerve injuries, including brachial plexus compression. For example, if there is nerve compression in a certain area, local acupuncture points can be used to deliver stimulation directly to the edema area, which can eliminate edema and relax the meridians, which cannot be achieved by other oral medications. Specifically for brachial plexus nerve compression, I will use my clinical experience as an example to describe how to consider acupuncture points in the treatment of this type of patient. When we are not sure which part of the plexus is being compressed (usually EMG is required to determine the location of the compression) and the patient is experiencing upper extremity pain and numbness, we must take all possibilities into account. Therefore, when I treat brachial plexus nerve compression, the first point I take is the cervical pinch point, which is the point where the nerve roots of the cervical spine come out of the intervertebral foramen, and if there is compression in this area, acupuncture of the pinch point can solve it. The second point to be taken is the axillary point, for example, the Jiuquan point, the anterior shoulder point, and the posterior shoulder point. The stimulation can be done by using a mango needle, which can reach the disease. Thirdly, we need to take the elbow acupoints, such as Quchi, Shuzhe, and Xiaohai, which are very effective if there is nerve compression in the elbow canal. Next, we need to pay attention to the wrist acupuncture points, such as the Waiguan point and the Hegu point. We have clinical studies that have confirmed that these two points are very effective for nerve compression in the carpal tunnel area. Of course, this is only an introduction to the principles, but in practice, the acupuncture points are not so simple. Depending on the severity of the patient’s symptoms, there may be additions or subtractions. In addition, the clinical practice of which acupuncture points should be treated with electroacupuncture and which with moxibustion depends on the doctor’s experience.