Just to flesh out more information in case anyone is interested or wants to actually read it all and let me know if they feel my recent diagnosis of TOS is reasonable, I'm posting it now. I probably should have included it in the main post, but I wasn't sure how much detail I should go into for my first post. Here goes:

Age <10
- Hand pain and shoulder hunching begin
- GP visit in Clarenville, NL
- Told not to worry, apply heat, would grow out of it
- Pain continues but is not a detriment

Age 12-13
- Move to St. John’s, NL
- Deformity of pinky finger becomes apparent
- Playing of musical instruments discontinued due to loss of mobility in right pinky finger
- GP visits in St. John’s, NL and continue regularly to age 24
- Sent to pediatric specialist who diagnoses general deformity
- Use of hand splint is recommended to straighten finger
- Is completely ineffective, specialist is inexplicably satisfied with results, treatment is discontinued
- Pain continues but is not a detriment

Age 13-17
- Hand deformity continues to worsen to present, pain increases
- Coldness of hand is noted as often accompanying pain
- Tingling and “hitting funny bone” sensation becomes common and continues to present
- Pain begins to manifest in wrist area
- Severe tension headaches become commonplace and continue to present
- Given anaprox and other anti-inflammatories for pain

Age 18
- While working at Tim Horton’s, pain worsens and becomes debilitating
- Work is discontinued for the next year approximately due to increased amount of pain
- Pain begins to manifest in shoulder and neck area, is first diagnosed as repetitive strain injury
- Physiotherapy is begun as possible treatment and includes acupuncture, exercises, ultrasound and neck traction
- Recommended muscle relaxants to treat pain
- Also prescribed Atasol 30 (30 mg codeine) on and off for pain

Age 19
- Due to internet research, the possibility of ulnar nerve compression is addressed with doctor
- Physiotherapy is continued
- X-rays of neck, upper back and shoulder are ordered
- No abnormal results noted
- Sent to neurologist who does minor physical examination
- MRI is ordered by either GP or neurologist, no further contact with neurologist
- MRI diagnoses missing 1st left rib
- Prescribed 2400mg of ibuprofen per day for pain

Age 20
- Pain becomes manageable, resume work as cashier at grocery store
- Continue physiotherapy
- Begin working as physiotherapy aide
- Continue taking ibuprofen 2400mg daily
- Also prescribed amitriptyline daily for pain management
- Significant loss of mobility becomes apparent in hand

Age 21
- Pain once again becomes debilitating, off work for about another half year
- Eventually get medical clearance to return to school
- Pain becomes somewhat manageable
- Begin massage therapy
- Continue taking ibuprofen
- Hand muscle wasting becomes apparent, as well as loss of grip strength
- Pain in upper back (cervical spine) continues to worsen to present

Age 22-23
- Pain continues at fairly irregular levels of intensity for extended periods
- Sensitivity to prescription NSAIDs becomes apparent (stomach issues, including ulcers)
- Sometimes pain is manageable and only minor discomfort, other times it is completely debilitating for up to weeks at a time
- Prescribed toradol for pain
- Loss of dexterity and hand strength becomes apparent

Age 24-25
- Hand and arm pain continues and worsens
- Upper and lower back pain continue to worsen
- Muscle wasting in elbow becomes apparent
- Dexterity loss becomes significant
- Move to Ontario in order to have access to more qualified specialists
-GP visit in Pickering, ON
- X-rays ordered which diagnose cervical rib on right side, not missing rib on left
- X-rays diagnose spinal disease in upper back (arthritis)
- Ultrasound of elbows normal
- Sent to physiatrist for nerve conduction study which indicated nerve compression at elbow and permanent nerve damage
- Electromyography was also performed that indicated permanent muscle damage
- Physiotherapy and massage therapy no longer recommended due to the unknown nature of injury and in the interest of not worsening condition
- Visit to neurologist begins investigative testing process

At the beginning of May 2012, severe swelling of the right hand and forearm became a problem
- Significant pain and discomfort came with swelling that caused inability to continue at work, was placed on short term disability
- Naproxen 250mg twice daily prescribed primarily to control swelling and is somewhat effective, although not completely
- Tylenol 3 prescribed daily pain relief as needed
- Zopiclone 7.5mg prescribed for sleep disturbances due to pain
- Neurologist prescribed gabapentin (1800mg daily) in an effort to get pain under control, it is not entirely effective
- Hand x-rays ordered in May came back normal
- MRI of neck/upper back did not show point of nerve injury
- MRI of shoulder/brachial plexus did not show point of nerve injury
- Secondary nerve conduction study and electromyography was performed that indicated cubital tunnel syndrome
- MRI of elbow did not show point of nerve injury

Referred to chiro/physio
- Diagnosis of N/A TOS is given (problem at elbow deemed to be simple nerve damage as a result of long term TOS)
- Treatments include massage therapy, chiropractic adjustments of back, neck and cervical rib as well as physiotherapy (TENS, exercises, stretches), treatment of fibrous adhesions in neck and shoulder.
- Attempts have been made with exercises and stretches to restore nerve gliding and allow neck and shoulder muscles to relax and lengthen.
- If treatments are not effective, surgical consultation will be booked.



Here is my list of other neurological symptoms and since I am new to learning about TOS, I am unsure if any or all of them can be attributed to TOS.

- Diagnosis of Bell’s Palsy at age 10 on left side of face. No specialist was consulted or tests ordered. Some mild facial paralysis persists to present, but has become progressively more obvious since approximately age 22.

-Progressing clumsiness and inability to concentrate persists to present, first noticed at approximately age 22. Diagnosis of Adult ADHD was discussed, but symptoms were absolutely not present in childhood.

- Vertigo and tinnitus began at approximately age 13, progressing to present with sometimes long periods between “episodes”, but these periods are becoming shorter and less frequent since age 21. It is worth noting that the vertigo symptom is not situational in that it is not related to any type of movement, but seems to be a spontaneous symptom. For example, rollercoasters are not an issue at all and do not cause dizziness. Was diagnosed initially as Labyrinthitis, after it persisted, Meniere’s Disease was suspected but never investigated.

- Mild conductive hearing loss for low frequencies noted in left ear as well as evidence of middle ear pathology bilaterally. First noted as per test results dated 11/12/00.

- Severe muscle stiffness in upper back and neck resulting in shoulder hunching has progressed since becoming noticeable at approximately age 10. Muscle spasms and cramps became frequent around this time and persist to present intermittently. A clavicle strap was ordered at age 20 in an attempt to correct posture. X-rays have shown disc space narrowing in the upper back (2011). MRI has shown DDD, disc space narrowing, stenosis and 4 herniated discs (2012).

- Overactive dilator muscle or pinched optical nerve was noted by an optometrist as possible cause of excessive pupil dilation in eyes at all times, as well as mostly sluggish or sometimes non-existent reaction to light shone directly into eyes. Ex: Pupil dilation at all times is sufficient to cause red eye effect in real life, as well as in photographs.

- Lower back pain became bothersome at approximately age 21, with episodes of extreme pain resulting in almost completely restricted mobility for always less than a week. However, lower back pain, to a mild extent is almost always present, especially in the morning. X-rays have shown degenerative disc disease and disc space narrowing in the lower back (2012). This pain radiates down the right leg to mid-thigh and causes muscle trembling and weakness in the affected leg. Localized numbness has been noted in toes of the the right foot intermittently since approximately age 21.

- Night sweats became a troublesome issue at about the same time as swelling in the right hand. Episodes were excessive with enough sweat to drench bed clothes but without the feeling of being overheated whatsoever.

- Iron Deficiency Anemia was diagnosed at age 16, and iron levels have been consistently low despite daily iron supplements. Anisocytosis was first noted in 2008.

Sorry this is so long and kudos if you got through it. I really appreciate it!!!!