Hi All,

I just registered and posted an introduction here, and would love to hear opinions on the following.

I'm currently receiving physical therapy under the Barral system. I've had 6 sessions so far, and no noticeable change in symptoms during the 3 weeks in which these sessions have been held. In addition to the sessions, I have homework in the form of a series of stretches for the pec minor, scalenes and brachial plexus area.

I've just been offered the chance to receive scalene block injections from the neurologist that diagnosed me with TOS. They are offered as a therapy rather than an additional diagnostic, albeit I understand they would perform both functions.

I'm concerned that if I take the injections whilst continuing the therapy, and I experience relief, I may not know what *worked*. I'm further concerned that if injections provide relief, what that means for the long-term.

So my queries mainly are the following, but any comment, experience and counsel is welcome:

What are your thoughts on receiving both physical therapy and block injections simultaneously?

Are block injections a sustainable solution?


Copied from from intro thread

I'm a 34 year old male. I'm an office/desk worker and until 2 months ago very active physically via resistance exercise, cycling and climbing.

I've been diagnosed by a Neurologist with bilateral vascular and neurogenic thoracic outlet syndrome, combined with bilateral ulnar nerve entrapment, which I believe can also be described as double crush syndrome.

The diagnosis was made on the basis of:

# My description of symptoms
# Physical exam by a manual physical therapist and neurologist
# Electromyography and Nerve Conduction Velocity exams
# MRI of my upper back/neck/shoulders
# Ultrasound to measure arterial blood flow upon abduction of the arms
# X-Ray to look for cervical rib or other abnormality

My first symptom, which lasted for 2 months before I sought help, was awakening from sleep with numbness present in left and/or right hand 4th and 5th digits. That was my one and only symptom for 3 months. After 3 months, and to the present day, my main complaint is that within 30-45 minutes of sitting/standing/walking with my head and neck unsupported, I develop pain in the rear neck area, which sometimes spreads to my trapezius and shoulders. I have less serious and frequent pain in my ulnar nerve around the elbow and forearm.

I'm currently undergoing physical therapy with a physio using the Barral system (a french physio)