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Thoracic outlet syndrome
Year 2001 - Stood up very sharply and hit my head on an immovable object. Drove my head down and back very hard. Actually was unconcious for about 25 seconds.
Medical findings:
2nd and 5th cervical disc buldging MRI
Thoracic Outlet Syndrome - Neurologist - EMG
Symptoms:
Numbness and tingling 4 - 5th digits both hands. Worse in right hand extending past the wrist.
Often severe neck and shoulder pain, right side. Med Mepregan
Bad Headaches.
Often severe pain extending down right side of neck to shoulder blade.
Right shoulder pain in bicept tendon area. Has gotten a lot worse in last year.
Sharpe pain in right thumb. Comes and goes quickly
Cannot use right arm raised above head or continued use such as typing or use of tools.
Loss of strength in right arm and hand.
My most recent Dr., a Pain Management Specialist, in reviewing my records noticed the Thoracic Outlet diagnosis and wants to persue with another exam by a Neurologist.
This injury is a Workers Compensation case, and as you can guess I've been treated like .. well you can guess.
1. Does this sound like a worsening condition of Thoracic Outlet Syndrome?
2. Can this condition, due to an injury, become irreversible if not treated timely?
I'm really tired of the pain and losing a lot of my life.
Thank you
Medical findings:
2nd and 5th cervical disc buldging MRI
Thoracic Outlet Syndrome - Neurologist - EMG
Symptoms:
Numbness and tingling 4 - 5th digits both hands. Worse in right hand extending past the wrist.
Often severe neck and shoulder pain, right side. Med Mepregan
Bad Headaches.
Often severe pain extending down right side of neck to shoulder blade.
Right shoulder pain in bicept tendon area. Has gotten a lot worse in last year.
Sharpe pain in right thumb. Comes and goes quickly
Cannot use right arm raised above head or continued use such as typing or use of tools.
Loss of strength in right arm and hand.
My most recent Dr., a Pain Management Specialist, in reviewing my records noticed the Thoracic Outlet diagnosis and wants to persue with another exam by a Neurologist.
This injury is a Workers Compensation case, and as you can guess I've been treated like .. well you can guess.
1. Does this sound like a worsening condition of Thoracic Outlet Syndrome?
2. Can this condition, due to an injury, become irreversible if not treated timely?
I'm really tired of the pain and losing a lot of my life.
Thank you
Oh, and my neck is always sore. When I massage it or press between the neck and shoulder-it sends sharp pain down my shoulder and arm. When I lay my head back to get it washed at the salon, I have NO STRENGTH to hold my neck up. Oh, and I seem to be nauseous and have noticed occasional headaches. Oh, and have been suffering with TMJ on that right side which strangely is now better.
Hi JainMD! I am a 42 yo female laparoscopic surgeon living in Atlanta and am having symptoms c/w TOS and I'm totally scared. I have severe weakness in my right arm, tingling down my arm-medial to the ulna and into my medial three fingers. My thumb hurts. It's worse with my hands forward (like to drive or operate). my sensory is blunted and my right hand is colder now than my left. I have some weakness and joint pain of the wrist and fingers. My right scapula is exquisitely sore, as well as the biceps and the area of the pect minor. At times I'm noticing some tingling in my legs as well-right greater than left. The MRI I had of the cervical spine showed a slight bulge at C7 T1 that the neuro thought was clinically insignificant but noted loss of cervical lordosis and thought this was due to a muscle spasm. I got cervical plain film which has not been formally read but I understand to have some arthritic changes and bony build up at C7 or so. I had a ncv study and am waiting for the results. I'm really scared.
Maybe I live in the Black Hole of treatment or belief in or for TOS.
How could I determine or search for a Physician who is knowledgeable, schooled, or whatever in TOS in my area?
My area? Chattanooga, TN
How could I determine or search for a Physician who is knowledgeable, schooled, or whatever in TOS in my area?
My area? Chattanooga, TN
Hi Mike,
I did get your point as to what is stopping you from getting treatment.
As the days progresses the condition would be worse and ultimately you would land up in surgery.
You mean to say that the doctors are not convinced about Thoracic Outlet syndrome (TOS).
Part of therapy of TOS is to make the patient understand about the condition.
Explanation of the pathologic process of TOS helps to alleviate a patient's concerns and makes the patient more receptive when instructed to avoid certain activities and postures.
Specific contributory factors, such as repetitive elevated positioning of the arms at work, should be identified and, when possible, addressed.
Has anybody told you about surgery or what surgery could be planned?
Keep me informed and take care.
Bye.
I did get your point as to what is stopping you from getting treatment.
As the days progresses the condition would be worse and ultimately you would land up in surgery.
You mean to say that the doctors are not convinced about Thoracic Outlet syndrome (TOS).
Part of therapy of TOS is to make the patient understand about the condition.
Explanation of the pathologic process of TOS helps to alleviate a patient's concerns and makes the patient more receptive when instructed to avoid certain activities and postures.
Specific contributory factors, such as repetitive elevated positioning of the arms at work, should be identified and, when possible, addressed.
Has anybody told you about surgery or what surgery could be planned?
Keep me informed and take care.
Bye.
I was "treated" by a Spinal Surgeon for the first 5/5 years after the injury. Sent to physical therapy twice. He played down the diagnosed TOS by the Neurologist as "to controversial".
The Neuro did an EMG and physical in '02.
I've had three MRI's and a Mylogram. Three independent DR's exam. One a Emory University in Atlanta. All three concluded that the buldging disc's were not impinging on the nerves. The Emory Dr told me the nerve damage was "done"! I have been diagnosed with arthritis in the 2nd and 5th cervical. A little elsewhere in the body due to injuries but not bad.
NO diabetes, NO alcohol use, NO thyriod problems!
My Pain Management Dr, in reviewing my records saw the TOS and is wanting to send me to another Neuro Dr for re-exam.
My posture:
I pretty much keep going to the head down posture. I have been fighting this to no avail. My right shoulder seems to ride higher than the left. Less pain that way I guess, not a concious thing!
I work at range of motion on a weekly basis, but as time goes by this gets harder to do.
Thank you for the response and information. I guess to endure pain - pain must be endured!
I really appreciate hearing from someone who believes this condition is REAL!
The Neuro did an EMG and physical in '02.
I've had three MRI's and a Mylogram. Three independent DR's exam. One a Emory University in Atlanta. All three concluded that the buldging disc's were not impinging on the nerves. The Emory Dr told me the nerve damage was "done"! I have been diagnosed with arthritis in the 2nd and 5th cervical. A little elsewhere in the body due to injuries but not bad.
NO diabetes, NO alcohol use, NO thyriod problems!
My Pain Management Dr, in reviewing my records saw the TOS and is wanting to send me to another Neuro Dr for re-exam.
My posture:
I pretty much keep going to the head down posture. I have been fighting this to no avail. My right shoulder seems to ride higher than the left. Less pain that way I guess, not a concious thing!
I work at range of motion on a weekly basis, but as time goes by this gets harder to do.
Thank you for the response and information. I guess to endure pain - pain must be endured!
I really appreciate hearing from someone who believes this condition is REAL!
Hi Mike,
Have you seen any doctor for your symptoms? What are the imagings studies being done?
I want you to take treatment as early as possible as there are other conditions which can rise due to thoracic outlet.
It is believed that a nerve that has some degrees of compression in the neck is more sensitive to nerve compression problems at other points along its course, such as at the elbow or the wrist.
Thus, patients with TOS are more susceptible to developing Cubital Tunnel Syndrome, and vice versa.
This phenomenon has been termed the double crush syndrome.
Do you have arthritis, diabetes, and alcoholism or thyroid disease?
Patients with arthritis, diabetes mellitus, thyroid disease, and alcoholism have nerves with increased susceptibility to the development of superimposed nerve compression.
The cornerstone of nonoperative therapy is a carefully regulated program of muscle strengthening and postural re-education exercises.
Exercises must be continued until muscular atrophy and weakness is reversed and correct posture is developed.
If a carefully supervised exercise and postural program fails, and the patient has intractable pain, surgery may be indicated.
Hope this helps you.
Keep me informed about your decision and any consultations hereafter.
Bye.
Have you seen any doctor for your symptoms? What are the imagings studies being done?
I want you to take treatment as early as possible as there are other conditions which can rise due to thoracic outlet.
It is believed that a nerve that has some degrees of compression in the neck is more sensitive to nerve compression problems at other points along its course, such as at the elbow or the wrist.
Thus, patients with TOS are more susceptible to developing Cubital Tunnel Syndrome, and vice versa.
This phenomenon has been termed the double crush syndrome.
Do you have arthritis, diabetes, and alcoholism or thyroid disease?
Patients with arthritis, diabetes mellitus, thyroid disease, and alcoholism have nerves with increased susceptibility to the development of superimposed nerve compression.
The cornerstone of nonoperative therapy is a carefully regulated program of muscle strengthening and postural re-education exercises.
Exercises must be continued until muscular atrophy and weakness is reversed and correct posture is developed.
If a carefully supervised exercise and postural program fails, and the patient has intractable pain, surgery may be indicated.
Hope this helps you.
Keep me informed about your decision and any consultations hereafter.
Bye.
Thank you for your response.
My name is Mike B, I'm 59 years old and up to 6 years ago a very physically fit person. I retired from my job last Jan because I was relagated to a desk job using a computer 8 hours a day which only made my condition worse. Funny, nobody believed that!!!!!
As I stated the injury was a very sever whip back of my head and neck from an obstruction when I was standing up. I was moving from a crouched position upward at a fast rate.
My continuing symptoms are:
neck cramps, followed by headaches
right trapazoid muscle cramps, quite sharpe at times.
both hands - numbness in 4th - 5th didgets,
pain in right thumb and right arm.
The symptoms that have gotten worse over the last 6 years:
Right shoulder pain into the bicep.
Shooting pain in right thumb.
Right arm going numb.
Lose of mobility of right arm.
I'm hitting a wall here and can't seem to get any Medical help or relief except for pain medication.
I appreciate any advice!
Thank you
My name is Mike B, I'm 59 years old and up to 6 years ago a very physically fit person. I retired from my job last Jan because I was relagated to a desk job using a computer 8 hours a day which only made my condition worse. Funny, nobody believed that!!!!!
As I stated the injury was a very sever whip back of my head and neck from an obstruction when I was standing up. I was moving from a crouched position upward at a fast rate.
My continuing symptoms are:
neck cramps, followed by headaches
right trapazoid muscle cramps, quite sharpe at times.
both hands - numbness in 4th - 5th didgets,
pain in right thumb and right arm.
The symptoms that have gotten worse over the last 6 years:
Right shoulder pain into the bicep.
Shooting pain in right thumb.
Right arm going numb.
Lose of mobility of right arm.
I'm hitting a wall here and can't seem to get any Medical help or relief except for pain medication.
I appreciate any advice!
Thank you
Hi Tenvic,
How are you feeling? What is your name?
The 3 major causes of TOS are anatomic, trauma/repetitive activities, and neurovascular entrapment at the costo-clavicular space.
Anatomic
Scalene triangle: Anterior scalene muscle frontally, middle scalene muscle posteriorly, and the upper border of the first rib inferiorly account for most cases of neurologic and arterial TOS.
Cervical ribs and congenital fibro muscular bands are also causes for TOS.
Trauma or repetitive activities
Motor vehicle accident hyperextension injury is one of the causes.
Neurovascular entrapment: This occurs in the costo-clavicular space between the first rib and the head of the clavicle.
It is indeed sorry to say that as the time elapses more, more would be fibrosis and more would be symptoms.
Keep me informed.
Bye.
How are you feeling? What is your name?
The 3 major causes of TOS are anatomic, trauma/repetitive activities, and neurovascular entrapment at the costo-clavicular space.
Anatomic
Scalene triangle: Anterior scalene muscle frontally, middle scalene muscle posteriorly, and the upper border of the first rib inferiorly account for most cases of neurologic and arterial TOS.
Cervical ribs and congenital fibro muscular bands are also causes for TOS.
Trauma or repetitive activities
Motor vehicle accident hyperextension injury is one of the causes.
Neurovascular entrapment: This occurs in the costo-clavicular space between the first rib and the head of the clavicle.
It is indeed sorry to say that as the time elapses more, more would be fibrosis and more would be symptoms.
Keep me informed.
Bye.
I have reregistered because I forgot my other password etc.
I have endured and the symptoms have gotten worse since the accident. No real repetative movement in my, former, occupation. A Neuro gave me the TOS after the EMG, accupuncture needle thing, and a physical exam.
I am trying to get approval to see another Neuro, after nearly 6 years since the last one. I have been given physical therapy several times since '01 and a wheel barrow of drugs. Being this was an on the job accident, and I was a Federal Employee, I fall under the "you get screwed" act of Workers Compensation Act.
Ley5792
Any manipulation by a therapist or deep tissue massage causes me extreme pain followed by acute apathy because of increased drug use for pain. I'm going to wait for this new Neuro exam before I venture there again.
My biggest Question is:
Has the time lapse since the injury going to cause me more problems?
Can TOS REALLY be injury induced?????
Thanks for the write backs and I'll keep my password etc.
I have endured and the symptoms have gotten worse since the accident. No real repetative movement in my, former, occupation. A Neuro gave me the TOS after the EMG, accupuncture needle thing, and a physical exam.
I am trying to get approval to see another Neuro, after nearly 6 years since the last one. I have been given physical therapy several times since '01 and a wheel barrow of drugs. Being this was an on the job accident, and I was a Federal Employee, I fall under the "you get screwed" act of Workers Compensation Act.
Ley5792
Any manipulation by a therapist or deep tissue massage causes me extreme pain followed by acute apathy because of increased drug use for pain. I'm going to wait for this new Neuro exam before I venture there again.
My biggest Question is:
Has the time lapse since the injury going to cause me more problems?
Can TOS REALLY be injury induced?????
Thanks for the write backs and I'll keep my password etc.
Hey TennVic,
Regardless if you have TOS, or something else. I recommend you see a Licensed Massage Practitioner. They work to manipulate underlying soft tissue (i.e., muscles, tendons, etc.) and help the body return back to a neutral position, reducing unnecessary stress on joints and nerves. My LMP has treated many clients with TOS successfully. There is hope and you can get your life back.
Regardless if you have TOS, or something else. I recommend you see a Licensed Massage Practitioner. They work to manipulate underlying soft tissue (i.e., muscles, tendons, etc.) and help the body return back to a neutral position, reducing unnecessary stress on joints and nerves. My LMP has treated many clients with TOS successfully. There is hope and you can get your life back.
Hi Tennvic,
How are you feeling now? Did your work involve doing repetitive movements of any joint, especially upper limbs?
When where you diagnosed as having Thoracic outlet syndrome (TOS) and on what basis where you diagnosed?
The diagnosis is based on the Selmonosky Triad during physical examination. This consists of Elevation of the hands, supraclavicular tenderness, weakening of the 4th and 5th fingers.
Your MRI was reported as having disc bulging of Cervical 2nd to 5th vertebrae. This can also be the cause of your symptoms.
Before diagnosing Thoracic Outlet Syndrome (TOS), cervical vertebrae pathology needs to be ruled, which in your case is quite evident that it might be cervical vertebrae pathology causing the symptoms.
I would recommend you to see another neurologist and an orthopaedician to re-evaluate and re-diagnose your case.
What treatment modalities have the doctors planned after diagnosing you of having TOS?
Keep me informed about your disease progression and about your discussion with doctors.
Bye.
How are you feeling now? Did your work involve doing repetitive movements of any joint, especially upper limbs?
When where you diagnosed as having Thoracic outlet syndrome (TOS) and on what basis where you diagnosed?
The diagnosis is based on the Selmonosky Triad during physical examination. This consists of Elevation of the hands, supraclavicular tenderness, weakening of the 4th and 5th fingers.
Your MRI was reported as having disc bulging of Cervical 2nd to 5th vertebrae. This can also be the cause of your symptoms.
Before diagnosing Thoracic Outlet Syndrome (TOS), cervical vertebrae pathology needs to be ruled, which in your case is quite evident that it might be cervical vertebrae pathology causing the symptoms.
I would recommend you to see another neurologist and an orthopaedician to re-evaluate and re-diagnose your case.
What treatment modalities have the doctors planned after diagnosing you of having TOS?
Keep me informed about your disease progression and about your discussion with doctors.
Bye.
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