I can see that you really keep up with this group and very thankful for the time you've put in - I've read a good portion of your posts. I will respond below in the hopes that some of my replies will perk up some useful responses from others. Then I'll ask more questions at the bottom and, if you feel they've been answered before and I haven't found them, you can direct me to the proper place at your leisure. THANKS!!!!


Don't freak out , catching TOS or chronic RSI stuff as soon as possible is a good thing.


Is two months from the onset of symptoms (first in the little finger) catching it early? I suppose in comparison to years, it is...

What kind of instrument do you play?
Anything with arms forward & head forward { most instruments}, reps & long hours of practice can really impact the body/posture relationship.


I play viola and piano, and this is mostly on the left side (though also on the right). It seems fairly straightforward from that standpoint: Neck forward, arm elevated, laptop use on the subway, heavy backpack use = bad!

I don't practice long hours, but I was doing a lot while on the crutches, which was really the thing that set if off.

Any previous injuries? whiplash, hyper mobile? these factors add up too.
The crutches use adds to it too.


Save a fall while on crutches (onto my back, no big deal), no previous injury. I think it's RSI over a long period...set off by less than ideal crutch use.

You can turn it around if it is myofascial based - but it's isn't a easy fix - takes time and rest & proper rehab and self care & posture awareness.


Ok, I had some questions about that, but please see them below. But, how can I tell if it's myofascial based? What exactly is the distinction between that and something else? Do you mean neurogenic in nature, primarily?


Do you make your living as a musician?


Part of it. I am exploring ways to make life work without it, and have some amount of financial security in order to make that happen in the short-term. Actually, there are other things I want to accomplish anyway, so in that sense taking 1-2 years off is not the end of the world for me.

What is your avg daily pain level now? {0 =none up to 10 = highest}
What are you most bothersome symptoms at this point?


It's nice of you to ask, and I could use some guidance there actually...

Mostly it's the ulnar distribution of the left hand - numb for 3 months, some pain into the 4th digit and (with activity) the whole hand. Tight chest, really tight neck and itchy shoulders. With any sporty activity (even not using hands), burning of arms into chest. Average pain 2-4, with too much activity 5-6.

for me -
self care- body work/posture, far infra red heating pad, trigger point self care as needed, Sharon Butler stretches & reverse posture stretches - only once in awhile now - back at the beginning of my injury many x's a day was my focus.

a really good chiropractor- does upper cervical & PT modalities too - ultra sound, IF stim, LLLT, NIMMO { had some misalignments from many many yrs ago}

A couple of advanced PT people were very helpful.

but the most important thing is to learn about it early on and work to reverse the damage before it becomes a major & permanent problem.


1) What are the Sharon Butler stretches (I assume they are mostly to stretch chest and neck, like my PT is already giving me). Are there stretches to avoid?
2) How did you learn the trigger points? Is there a post on them?
3) FAR Heating pad? Again, if there's info I'd like to know. What's FAR?
Also, what's IM Sim, LLLT, NIMMO??
4) You would go to a Chiro before a PT? The chiro I had also was focusing on the pec minors, but I think the seriousness of my condition scared her off - she isn't returning my calls. Some warn against them...
5) What do you mean by advanced PT? There's someone in NY who has trained with Edgelow, and I thinking of going to them (though my current PT - it's been 2 weeks - does good trigger point and neurofascial work and I feel much looser after a session). I called Edgelow to get their info, he was really nice!

MORE GENERAL POINTS AND QUESTIONS

No matter what, I AM educated now, many thanks to you and this site! I'm glad I found it as soon as the hand doc suggested TOS (and thankfully, he did so before I went through the classic shuffle...which I'm actually still going through).

My principal question is in regards to EMG's. Mine is not totally normal (first one was, but it wasn't done by a neurologist, second one did not specifically LOOK for TOS and the neuro wasn't convinced it was, hence no official diagnosis). Though it might cost me this time, I have considered a third one since I DO have some sensory loss along the ulnar and some "reduced recruitment patterns" in the inner hand muscles. How can I find the right person on the East Coast and is it worth it? Is this an accurate way to monitor progress (or lack thereof?). If I am losing use of my arm slowly, I think that might be a good reason for surgery, especially if I ever hope to play again. On the other hand, I FOR SURE would like to avoid the operation.

FYI: I've also had an MR angiogram (ordered by a doc I found on the ATOSA site in my network) that was normal. I'm assuming that doesn't rule out neurogenic TOS, and he confirmed that.

That's enough for now. I'm incredibly grateful for the response (admins feel free of course to bump the post if needed, as long as I can find the replies) and thank you in advance to anyone who has ideas for me. Hugs to all!

Joshua