Long Thoracic Nerve injury...will it heal?
 

This is a bit of a long read. I have been posting all over different forums looking for some insight. I have talked to my doctors but all they tell me when I try to get details is that it is a rare injury and there is nothing I can do but physical therapy and wait 2 years. I need to know my chances of recovery though. Alot in my life depends on it.

My story starts in early September 2010. I was at the tail end of some training I was doing in the Army. On the last day of our training we did a 70 lb ruck sack (a large backpack) march which lasted for about 1 hour. During this march I noticed my right arm going numb as if circulation was being cut off. So I would occasionally loosen the strap and this seemed to help.

After the march everything seemed fine. Later that day I also did some pullups which seemed to go as normal. It wasn't until the next day that I woke up with pain in my right arm. This went away after a couple days. However I had lost most strength and mobility in my right arm/shoulder. I couldn't do a single push up or pull up and if I tried to raise both arms straight above my head, the right arm can not go as high. I also have scapular winging.

I went the the on base doctor and was told it was a long thoracic nerve injury and that with rest I would be good to go in 4 months. Luckly training was done so I got to go home and didn't have to do anything that would really strain my arm anymore. However all the symptoms continued minus any pain well past the 4 month mark. I starting seeing my own doctor who referred me to an orthopedic doctor. He seemed to agree that it was a long thoracic nerve injury as well and had an EMG done on me. The EMG also supported that this is a long thoracic nerve injury. The neurologist who did the EMG and doctors told me the injury is somewhere between the moderate to less than sever side.

I was told that this could take anywhere from 18 months to over 2 years to heal. My biggest problem is that my career and life goals require me to be in physical shape. I am an officer with the Army National Guard and have to be able to take a PT test once this heals. If it doesn't I could possibly be med boarded out of the Army. Which I don't want cause I love it. As for my civilian career aspirations I wanted to start working on becoming a cop, since my major in college was criminal justice. Now I can't go about that since physical test are required to join any force.

I'm currently doing physical therapy but until my arm is 100% I'm more or less SOL with pretty much everything else I do in life. I also know surgery is an option but my doctors don't seem to think that would be the best choice. They tell me that might cause more harm than good to surrounding nerves and muscles. My question is what are my chances of this thing healing on its own? Also has anybody had experience with surgery? My biggest fear is that if I wait 18 months to 2 years then surgery won't be as effective.

There are some posts about LTN on the thoracic outlet syndrome forum. (TOS for short)
http://neurotalk.psychcentral.com/forum24.html

Or a whole site search might be a quicker way to locate those posts
http://neurotalk.psychcentral.com/search.php

Hi Scotty ~ I'm sorry you suffered this injury. It would have been better to have broken a bone!! It would have healed faster. :eek:

Nerves DO have the capacity to heal on their own. The AVERAGE rate of healing is one inch per month ~ that's the average. Some heal faster, some slower. So if you injured a LONG nerve, it could take awhile. :( It's best if you don't stress this area, but try to protect it as much as possible as it's already inflamed and irritated.

Were you given any anti-inflammatory meds to take? You can find some over-the-counter, such as Motrin. Take those ONLY as the instructions indicate, as they are hard on the stomach and can cause bleeding without warning. :eek: But these should help with the inflammation. If it's still painful, use ICE for 20 minutes every 2 hours. That also will reduce inflammation and pain. It could help speed up the healing process. But you will STILL have to be careful with it. Once you've injured an area like that, you're more apt to re-injure it. So try to protect it if possible.

Pain is NOT a good reason for surgery. Surgery only corrects mechanical problems and does NOT rid you of pain. Usually after surgery you are left with the SAME pain or worse. The doctor was right in telling you not to have surgery as the surrounding muscles/tendons/tissues WOULD probably be damaged and you would be worse off than you are now. Stay conservative and wait for this to heal on it's own. I wish you the very best. Hugs, Lee

I agree it sounds like a long thoracic nerve issue, but it can be more involved.
Doctors Parsonage and Turner were first to describe this syndrome in a 1948 study you may be interested in. It involved people in the military who tended to get the disorder after long marches with heavy packs.

Here is more info on it.

http://www.healthline.com/galeconten...urner-syndrome

I am a sufferer by the way, but not due to the same cause you have. It can heal, but as you know it takes a long time. In my case, I have improved, but not close to where I was originally. Then again, I have had more than one flare-up.

Good Luck!!!

scott what was your out come ??? Having the same issue
check out *edit* under the same name for pics and what the doc told me.. not spam

Thanks

what was the outcome ??? Having the same issue

bump bump

I'm sorry KrisMVT but I think it's unlikely that you'll get a reply from Scottyb825, as he's not logged in here since posting this once, 18 months ago.

I see that its been some time since you posted this and I'm curious if it has gotten better. I know my doctors put me on gabapentin and physical therapy and tell me to just wait. I'm a cook and its been really hard on me, I'm always in pain. When they did the EMG, they said that mine is severe damage. So let me know how you are doing, it would be nice to have somebody to talk to about this who has been through it.

I hear ya!
 

I have suffered with thoracic nerve damage for several years and was told I am one of 9 the Dr. has seen in 25 years. He was an Air Force Dr. if that means anything to you. He was fantastic. We tried three series of Shots in the back to kill the nerves to no avail, I tried massage, p/t and heat and cold and you name it. Nothing has helped. It started on the left side and is now wrapped all of the way around. Mine they guess may be caused by Hepatitis C being present for 35 yrs, now taking another track to get me. I just want to offer my support. I now take one small pain med at bedtime and just deal with it the rest of the time. I am nearly 60 so don't have the same worries you do. I wish you luck and healing. I was told by Dr. Justin Boge that surgery is not an option, there are 43 miles of nerves in the body to deal with. Sorry I could not offer better news for my part.

gmitch and Kris- any updates with you guys? I've been dealing with this unfortunate BS for the past 1.5 years, with it becoming disabling as of 4 months ago. I've had one unsuccessful surgery and now also on gabapentin and doing more PT but I feel like I'm still getting nowhere..

I'd love to talk to you guys and hear about your progress.

Long Thoracic nerve injury
 

Hi, I came across this when I was searching for more information about LTN injury/palsy. Mine was injured nearly 4 months ago during neck surgery to fuse the 5th and 6th cervical vertebrae. The incision is on the front of the neck, and then they use retractors to pull the muscles to the side so the vertebrae and disc can be accessed. Apparently during the retraction, my LTN was caught. It took awhile to get the right diagnosis. Immediate symptoms were intense, burning pain around the shoulder/scapula and down past my elbow. My arm was useless, couldn't hold onto a gallon of milk, my arm hung at my side like a rag doll, which made it hurt even more. I was unable to raise my arm past waist level, and my scapula had the classic "winging." The intense pain, which at the time was explained to me as "post op swelling pressing on nerves" kept me in the hospital for 4 days, which is much longer than the norm for this surgery (ACDF, or anterior cervical compression discectomy), which is either done outpatient or has a one night hospital stay. At the 2 week post-op visit the surgeon still was dumbfounded as to why I was having these symptoms, and didn't seem to want to entertain any thought of anything other than "swelling." I was referred to a Physiatrist who prescribed a very strong anti inflammatory and PT. That was a Godsend as it took the pain down enough to enable decent sleep. After 2 MRI's (one to the neck and one to the shoulder) that came out normal, an EMG was done and the problem was finally identified. Not that it made much difference to the treatment - Physical Therapy, anti inflammatories, and rest. Very functionally limited: unable to use right arm to wash/brush hair, to put plates on/off shelves, to reach inside the refridgerator, to reach the rearview mirror in the car (I didn't drive for 6 weeks), to carry anything with my arm away from my body. Finally, at 4 months, I'm getting better but still a long way from normal. I haven't yet been cleared to return to work as a Physical Therapist but hoping at next checkup in 2 weeks to clear that hurdle. I've accepted that this is going to take awhile. I continue to do the strengthening exercises for my shoulder/arm and they aren't as difficult. Still frustrated with how quickly my shoulder/arm fatigue! Just yesterday I was shocked to find I still couldn't tread water in the pool for more than a couple of minutes, and I've been a swimmer all my life. Female, age 47. I haven't found anything in the literature talking about this injury risk for the surgery I had. Would I have the surgery, knowing what I know now? Yup. This is temporary and will heal in time; my neck was a mess and now it's great.

Baloney...I've had over 30 "ops" and never, ever was I ever told anything that may damage anything...therefore...I had a SCS put in...now I'm crippled....
What a succkie system...More Mysteries then "The temple of Doom"

Thanks

Now to figure out what to do...another mystery to solve