I have arterial, venous, and neurogenic TOS, and am a candidate for surgery, but it won't be for at least 6 months, if at all.

I've just scheduled two less invasive procedures (one side this Tuesday morning, the other side a week later). The doctor uses CT guidance to put the needle in the muscle belly of the anterior scalene (avoiding the plexus), then pumps the muscle full of marcaine anesthetic (and maybe some neutral liquid, I forget what), in an attempt to blow up the muscle like a balloon, and break up adhesions.

Then, he releases botox into the muscle, to shrink it and relax it, with the goal of ultimately creating a modest amount of additional space in the plexus. The doctor said he wants to make sure the medication stays in the muscle, so each side he injects needs to be on full rest (can't use the arm at all) for a week after the procedure.

The whole thing is, he said, a "myolitic" procedure, which I think essentially means "muscle-destroying," though it definitely won't have the impact of an actual scalenectomy. According to MRNs, my scalenes are already atrophied, but they may be tight, and there may be adhesions in the plexus that didn't show up on the scans.

The cost will be about $2000 a side, and they don't bill insurance.

I think I am going to go for it, and see if I can't get this under control without the scalenectomy/resection. At a minimum, I am hoping this will make my life less miserable while I wait to figure out what to do about the surgery.

I had these procedures done (at the same place) 5 years ago, and they did help, maybe relieving 25% of my symptoms. I definitely thought it was worth it when I did it last time.

Now that I've discovered these forums, I just wanted to see if anyone has any thoughts or experience with this strategy? It's a lot of money, and it's two weeks of rest (I'll need to figure out child care!), but if it buys me a summer with less unbearable pain, and more arm function, I think it is totally worth it. The risks of making anything worse seem to be really minimal.

I am planning to have the first one done right away, and would appreciate any input. Thanks in advance!!!