###Human: How to rule out neck pain and numbness? ###Assistant: Hello. You have mentioned pain and numbness in your upper limbs after manipulation was done by a physical therapist. You have also mentioned both upper limb involvement which is actually a surprise because normal spinal manipulations should not actually lead to this especially if your cervical spine MRI is fine. To actually find out a cause for both your upper limb symptoms, a detailed neurological examination of both your upper limbs including assessment of motor power, sensory examination and evaluation of deep tendon reflexes, nerve conduction studies and CT angiogram of carotid and vertebral vessels can be done. There is an entity called as thoracic outlet syndrome which can actually lead to your upper limb symptoms, but bilateral involvement is not very common. Can you kindly send me the above mentioned details along with the investigations done by you till now? I can see and advise you accordingly. Also send me your blood investigations done recently as well. Will be based upon the investigation and clinical details as provided.