BACKGROUND: Patients who experience spinal injury and secondary paraplegia encounter a variety of risk factors that contribute to the development of subsequent upper extremity pathology. Trauma to surrounding structures, invasive surgical interventions, hardware placement, and overuse of the upper extremity among manual wheelchair users may further increase this risk.

CASE REPORT: A 36-year-old woman suffered spinal and rib injuries, requiring surgical fixation, and recently developed paresthesias in her upper extremities. Prolonged manual wheelchair use presumably contributed to further associated injury. Thorough evaluation of the patient, including electrodiagnostic studies, supported a diagnosis of carpal tunnel syndrome. However, additional factors in the patient’s history and physical examination findings supported concomitant thoracic outlet syndrome.

CONCLUSIONS: Our case emphasizes the importance of recognizing the nonclassical presentation of peripheral compression syndromes, performing a thorough evaluation, and providing the most appropriate management to promote optimal functioning and ultimately preserve one’s quality of life.

KEYWORDS: Paraplegia, carpal tunnel syndrome, case report, manual wheelchair use, thoracic outlet syndrome