My 14 year old dtr has received a diagnosis of compressed long thoracic nerve. It began in the fall when she (currently 5'4" and 100 pounds) played the tuba in her high school marching band. She also played softball on non band days. She complained of shoulder pain on and off but by Oct. She was in constant pain and said her arm felt weak. She saw an orthopedic who called it "unstable shoulder" and we were off to PT. It seemed to help with movement initially but never the pain. Then about 3 weeks in to PT it got worse. F/u with orthopedic was disappointing when he didn't even have her take off sweatshirt to look at winging scapula. I found a pediatric ortho who ordered MRI of shoulder (normal) and referred to neurologist which lead to an abnormal EMG and dx of LTN compression injury. Neuro called on phone and said poor prognosis for recovery and told me to f/u with pedi ortho and then see when I would go back to her. Neurologist gave no treatment ideas at all except do nothing for 12-18 months and see. I am looking for second opinion but wonder if should be surgeon. ???microvascular??? I hear of nerve surgery for severed nerves. Need ideas for next step please

Hello and Welcome to Neurotalk Support Groups

I am so sorry to hear about your daughter. It is hard when one's child is the one hurting and you want so badly to fix it. You will find many understanding people here.

You might find the following areas helpful

Thoracic Outlet Syndrome There are "Sticky" threads at the top of that board with useful info and introductions.

Children's Health This will put you in touch with other parents.

There are Search and FAQ features at the top of every page to help you with specific topics and common forum use questions.

Nerve injuries are tricky and really do require specialized training. I have had Peripheral Nerve surgery myself and while it is useful for transections and entrapment I don't know if it would apply to your daughter's case or not. Some injuries, such as brachial plexus are commonly left for 12-18 months to see if healing will occur before something more invasive. That said, consults and information are always helpful and may help guide your treatment plan. One of the best nerve surgeons in the US, Dr. Susan Mackinnon says "Time lost is muscle lost" so if you notice atrophy or increasing weakness by all means get an opinion from a peripheral nerve, neurosurgeon or TOS expert sooner rather than later.

You will find a lot of useful info on nerve injuries from Washington University. http://nerve.wustl.edu

Hold on to hope. Healing and improvement is possible with time and your daughter is young and growing. Optimize her diet, avoid repetitive strain, keep up with good posture and any gentle PT, massage or chiropractic work that helps her without making her worse.

Hang in there Mom. I hope she finds relief and healing soon.

I hope she has stopped those activities?
They will just make it worse until the problems is resolved..and it might take awhile..

Use the search tool for - winging scapula

Expert PT is needed for these injuries, ask PTs about any additional training/skills.
I don't recall any with winging issues on the Thoracic outlet syndrome (TOS) forum having surgery for winging specifically..they may have had TOS surgery and the winging was till an issue..

Hello and welcome, happy to see you have come to be with us, it a great place to be. We have a great number and caring fellow members here, where you have find a supportive and relaxing place. Have fun looking into the different forums. Our shoulders are here for support in many ways.

Please keep us up to date on your condition. Again welcome, looking forward to seeing you around. My thoughts and prayers are with you.

Darlene

Yes she has stopped all activies-couldn't do them even if OK because of decreased ROM and pain. This is a bit different than TOS. We have a f/u appt. with ortho Wed and hope to get answers. The neurologist had very little to say so I am anxious for this up coming appt. I just don't want to wait the 18 months and then find out I should have pursued another option but be too late. Thanks!

CVand3,

I hope the appointment goes well. That Washington U nerve injury site specifically mentioned compression of the thoracic nerve as a reason for winged scapula and said PT is often the treatment. They do have a surgery for it but hopefully that won't be needed. I support your quest for quick info. It can make a difference. You certainly want to be sure what to do.

Id suggest conservative measures first. Please be sure its nerve compression and not antagnonist muscles playing havoc or postural issues causing compression (see TOS forum).

If you are in the US, this gent is regarded as an expert.

http://www.drnathbrachialplexus.com/...la_Trifold.pdf

Best of luck.