[dawn3063]

Hello, I have a question for my fello TOS'ers...

Ok, Does anyone have an ideas if this is most likely TOS related? I have always had a bad spasm/burning pain in my Thoracic spine between and under my shoulder blades. The pain became most sever when I would be using my arms held strait out in front of my body such as folding cloths etc. But lately this pain has become almost constant and at times sever. My left hand falls asleep everynight and my little finger and ring finger ache. I go to bed with it and wake up with it. My pain meds barley touches it... I had a Thoracic spine MRI done and it came back ok.

As most know I have bilateral TOS and had right sided scalenectomy Jan 06 and then a right re-do Jan 07 I didn't have a rib removed. I have been told I need to have my left side operated on due to nerve compression but am not doing so at this time due to an RSD diagnosis April 06 after my re-do.
I also had a revision of C5 C6 spinal fusion Sept 06.

So, What do you all think? Do you think this could be from the TOS? I am in the process of finding a new doc for my TOS.
I see my PMD next week "whom I really like" and will see what his take is on this sever pain.

Any ideas would be appreciated...

&
Dawn

[watsonsh]

Hmmmm I do believe the Long Thoracic Nerve innervates that area and those muscles.

Towelhorse wrote about some of it in this posts. I will search around for ya. I always get burning in that area. I think that nerve originates from the c spine. Ah its all connected

[Jomar]

Dawn - it sounds alot like when my rhomboids get strained.
Here's a link with pics of where they are-
http://images.google.com/images?um=1...en&q=rhomboids


the thing is they are a weak muscle and easiy over stretched/strained .
so I found when mine start hurting I need to really be aware of bringing my shoulders back and doing little squeezes or isometrics to "pump" them back into shape.

basically for me that pain/ache means I have not been good enough with my posture.

I hope the pics help you to figure out if it is the cause of your new pain.

[johannakat]

ditto Jo.

My back pain originated in the area where c8 was wrapped around my rib. I was told that the inflammation they saw during surgery was in the top 10% of any nerve inflammation they had seen. It is my biggest complaint and so far has not been helped by my surgery

I am hopeful that if I am patient that nerve will calm down in time and I will feel better. I have had temporary relief when my hellerworker woudl release back muscles. He told me that the rhomboids and traps tend to get stuck together....Hopefully when I do hellerwork again and the muscle is realeased now that the nerve compression is releived, it will be more likely to last.

I must point out that in my MRN with Dr Filler, he was very sure that my rib was not contributing to the compression of my BP, recommended just the scalenectomy, and yet when Dr Ahn operated, my nerve was wrapped around my rib quite badly, hence the severe inflammation.

Dawn, I woudl really encourage you to visit Dr Jordan and let him do an ultrasound on the area. He can see stuff that many other techniques cannot. He can't see everything, but he had some interesting comments for me about post operative scar tissue from various surgeons, so I KNOW he can see a bit of that.

The procedure is not that expensive, I had one in March and the bill to my insurance was $390.

Like Jo, it is brought on easily by computer work for me, and is the reason I can't sit in a chair for too long.

I wish you luck...
Johanna

[Sea Pines 50]

i think that what you're describing sounds exactly like some of my very own original TOS sx, dawn. but does it really matter whether it's coming from your TOS or your cervical syndrome, or something else, i mean... especially if you are not contemplating having any more surgery at this time?

i sometimes think we can drive ourselves a little crazy trying to figure out WHY we have some of these bizarre sx, and WHERE they are coming from. i know i do that to myself, anyhow. maybe it helps me postpone the inevitable just a little bit longer as i stumble and fumble down the tortuous path i'm on; who knows...right?

because what really needs to happen is i need to take an action and get myself into a good PT program when this kind of stuff starts raging out of control! and since i know i have TOS, that always, always, must be with a practitioner who is expert at working with a TOS protocol.

i am so envious of you, dawn, that you now have the opportunity to work with neil over at loma linda. he is going to be so good for you! now, dr. reynolds may not call what he does "PT" per se, and maybe that is a separate rx, but if i were you i would start with neil for the acupuncture and acupressure using the rx from that doc.

then get neil in a dialogue as he is working on you in one of your sessions, about the sx you describe here plus all of your other sx, dawn, and as things start unfolding, if it turns out that you do need to start a "western" type PT protocol in addition to what neil has to offer, then he will, i am sure, be able to recommend someone right there at loma linda for you to see in that capacity. it's one-stop shopping for you, from now on, girl!

just so everyone knows what i'm referring to here, neil is a wonderful man of thai heritage whom i met a few years ago through a facility related to the pain clinic dawn is involved with right now. he is just incredible, one of those people you meet if you're lucky who is a great healer. this was a year before my TOS dx and this man truly helped me and taught me a great deal. he is not only an acupuncturist and an acupressurist, but a t'ai chi master, a registered nurse and a major in the US army (he used to set up MASH units all over the world; i believe he has since retired his commision, however...). he lectures about the mind/body/spirit connection and just has an amazing amount of knowledge and wisdom... and the ability to bring out the best in people. funny as hell, and most importantly he will unblock your chi and help you to help your body "remember" how to HEAL...

you lucky duck!

alison

[DiMarie]

I agree with the rhemboids as Jo said. That is where my primary problem is. I also have the knife in the back above the shoulder blade.

Generally I find it is flared with activity related. If I decide to drive to phila; I am hanging clothes orfolding them, wash a wall down is a sure flare. I can do most activities a little...I can not do them for more then 20 minutes without breaks, and can not do them all day.

Have you gotten a different car, drive more frequently, doing more laundry at one time.

Just some thoughts:
When Muscles are weak and in distress, they are typically protecting a nerve.
The long thoracic nerve could have the back muscles making a splint around them and then this travels to the rhemboids...like "you know what" flows down stream.

Not RSD spreading, it is the nerves from the nerve roots becoming more inflamed. rest, rub it out , hot tub, lay clothes on your lap instead of out in front of you.

IF you can take coated asprin I would try that to calm things down. If you tolerate zanaflex that works on the nerve where it inserts into the muscle. I started a 1 mg dose for two weeks then to a 2 mg, for a few weeks and finally up to 4 mgs.....

The key is calming the nerve so the muscle lets go of its grip and compression.
Hope you find out what is wrong at the doctors, he may help with some trigger point injections, near the underside and above the wing, but not too close to the armpit to hit a lung.

At least let him get the one on top of the wing...

I can feel mine traveling now to the area under my arm coming from behind the arm pit headed down y arm..where the flabby part I call it is. If I grab this underarm area now it is very tender too.

I never had surgery Dawn,
Di

[phoebe]

I have always had most of my pain around the shoulder blades and collarbone. I think most of mine are trigger points, and massaging them (hard enough to release them), on those really tender areas helps me. The trick with me is not too long and not too hard or it will just make the symptoms worse. With your surgical history, I don't know if this is even applicable to your situation.

Allison made a good point, and one that has taken me a long time to figure out. I'm not sure if most of my problems are in my c spine, or in the brachial plexus. I know I have impingement in my c-spine. I'm curious, but not curious or uncomfortable enough to find out right now.

Posture is my most consistent problem. Usually if I'm hurting, I've either done something physical with my upper ext. (driving, folding clothes, etc.) or my posture has become absymal again. Hope this helps a little. phoebe

[olecyn]

I'll try and write later ABOUT THIS SUBJECT MATTER
My new PT has resolved just about ALL of this for me
But it comes back when I forge ahead.
It's called modifying your life restrictions.
Not cured...aware of body mechanics, postural modalities and trap maximus strengthening

[dabbo]

Olecyn- is what you're talking about like the feldenkrais awareness thru movement stuff?

Dawn- i'm sorry to hear that you're havin that (more) pain. That has been one of my chief complaints....Dr. has given me TPI's which helped ALOT. I'll be interested to see how they treat you. Like Di said, anything with holding my arms out front, folding laundry, etc tweaks it. that, and if I do my exercises wrong (like this morning....) owwwwwwwwwwwwww. anywho

[olecyn]

YES,
Movements by micro movements, the awareness and ability to do anything slow as in Feldenkrais.
It took me 2-3 weeks before my doc of PT started out doing the perscribed trap max/minus strrengthening.
And it took me weeks to get it going.
You say, STRENGTHENING with TOS? Never as I learned the hard way
However, there are conclusive exceptions to the law of TOS.
Our posture is the culprit from doing what we did best in our careers or injured.
The trapezius muscles, cervical spine and shoulder girdle are weakend by the stress.
We have to begin strengthening these muscle areas that came crashing down or all the surgeries in the world will not do anything for us.

Begin laying flat on the floor. The floor is now my bestest friend.
Think Feldenkrais to start with and use micro movements bringing your trapezius muscles towards your spine and down tightening for a few seconds.
Then dor the other side.
You will find one side is easier than another and it it very hard when in pain to begin with.
Let me say 3 months later after my 911 cal and trip to the ER
Everbody comments on my posture.
It feels so good and take the pressure and burning off the muscles.
But as with anything like typing this
You have limits
It's my time to say I'll be back to add more.