23 y/o male TOS prepping for surgery
 

Hi all, just found this group recently and wanted to share my story.

I feel like this is going to be a long post... Honestly, I haven't ever come across so many stories that touch me and my own experiences so deeply. I find myself reading and reading and reading, so hopefully everyone won't mind a long post.

I've been diagnosed (yes, after lots and lots of confused doctors, extra pointless tests, and tons of referrals) with TOS on my left side. They *think* that I have compression of the brachial plexus due to some abnormalities in my ligaments (30% larger than normal). I have complete loss of bloodflow in both arms if I put my hands over my head, almost immediately. I have constant semi-numbness (50%) in my left hand fingers (left two) due to ulnar nerve compression. I have almost constant pain in my left shoulder, usually radiating from the end of my clavicle (near the shoulder socket) and especially in the area where the nerves and small bicep head rub over the shoulder bone.

I have a LOT of trouble sleeping. I have a hard time sleeping in almost any position, and the very strange positions that I do find help also flare up my neck and back, so it's always a trade off. Sharing a bed with my girlfriend always leads to a mostly sleepless night, constantly waking up with completely numb arms or severe/throbbing pain in my shoulder or arms. I wake up and use the bathroom 6-7 times a night and I'm pretty sure it's only because my shoulder pain wakes me up.

These symptoms have been around for 7 years or so, but maybe longer. I can identify two major periods of increased severity. The first was when I was 19 and had a MAJOR flare up trying to get back into swimming and weight training. A doctor told me it was a torn labrum (SLAP tear, usually in pitchers and swimmers from repetitive motion) after an MRI or two. I chose not to get surgery on this, as I had no money and was in college, spending loads of loan money already. Looking back, that year was probably one of my hardest. I must have been sleeping terribly, I did bad in classes, I was constantly forgetting things, my relationship with my girlfriend went from great to awful.

When I was 22, I hurt my back lifting weights (usually quite smart, but I believe my ego might have gotten the best of me that day). I think this was really the point where my life got out of control. I was heading into a doctoral program and just couldn't take time off. My posture is always terrible and has always been terrible. But, with my back messed up (MRI showed three bulging discs, but it was 6 months after the fact, with a probable tear of the fluid sac around a disc already healed) I have trouble not sitting up straight. BUT, my TOS flares up when I sit up straight. So I am always in pain. Nothing really solves either of these problems. I did a year of physical therapy, had numerous appts with specialists, have been on tylenol and ibuprofen around the clock for months at a time until I'm too sick of being medicated to do it anymore.
I'm on gabapentin (sp?) for nerve pain, but that only seems to mitigate it slightly... I've also sought psychiatric help because (I think) my lack of sleep has led to extra stress and I just wasn't the same person that I used to be. This has REALLY helped me a lot. I've been on Zoloft for about 6 months, and I can't believe how much it has helped me. I feel like myself again, for the most part. Still in pain and still having trouble sleeping, but I can finally manage my emotions and live my life in a similar fashion, even with flare ups.

I do a LOT of exercising to try to keep everything strong. I have read around and seen a lot of people recommending no weight training or activity for TOS symptoms, but personally I've found that keeping my muscles strong HELPS my day-to-day pain levels. Sure, it might hurt a lot during the exercise or from week-to-week, but a month later I feel better overall each day. Sometimes I can even sleep well.

Emotionally, this has been a wild ride. My senior year of college was really hard. I think I was severely depressed, but I got paired up with an on-campus counselor that pushed me away from medication. Terrible sleep, terrible relationships, always upset. I kept having thoughts of suicide and that's why I was seeing the counselor. Thankfully, I can think through the consequences of suicide and they seem stupid at all times, so it's just ideation. Still though, not where I thought I would be on the cusp of graduating college.

Now, in my second year of a doctoral program (how the hell have I managed to get this far, given the above??) I'm scheduled for a surgery for a ribectomy of the first rib on Dec 12th. The doctor (Hershey Medical Center, Hershey PA) plans to make an incision in my armpit and hopes to have the procedure be as minimally invasive as possible. They have a one month recovery hope. I do too, obviously, but I'm also wondering if that's too good to be true. Does anyone have a story similar to mine in terms of surgery? I've looked around and it seems like a lot of people have had severe TOS from trauma and have had other muscles removed... I feel for all of you! I was originally weighing the option of having a very similar procedure done to me with an outlook of a 1 year recovery and it DEFINITELY broke me to even think about going through that. Seeing another surgeon and telling me it might only take a month with their technique was a blessing.

I hope that surgery brings me relief and normality. I feel like that might be a dream though... I don't even feel 100% comfortable with my decision to get surgery (or that I NEED surgery) because I'm so invested emotionally in this outcome. Giving each option an honest shake has been difficult.

I'm really hoping to find some individualized support here. This has been such a trying experience and, as I see with so many others' stories, it is so hard to find someone to talk to who understands everything. Just sitting my friends down and telling them my story takes hours. Doctors look at me (6'3", 200lbs, in shape) and think I'm lying or trying to get attention. I am so tired and hurt and exhausted from trying to be heard that I feel like I can't even cry for help appropriately.

All the best,
Brad

Get to the best most experienced TOS docs you can find , vascular surgeons it sounds like what you need to look for.

[some abnormalities in my ligaments (30% larger than normal]

this should show with imaging , so is verifiable - if so that is a plus to know what might be the cause.. or part of the cause.

Has anyone helped you work on your posture?
I don't know if expert chiropractic might be helpful?
The one I found was very helpful and did PT modalities also.
ultrasound, low level laser, trigger point work, IF stimulation..etc..

this should show with imaging , so is verifiable - if so that is a plus to know what might be the cause.. or part of the cause.

Has anyone helped you work on your posture?
I don't know if expert chiropractic might be helpful?
The one I found was very helpful and did PT modalities also.
ultrasound, low level laser, trigger point work, IF stimulation..etc..[/QUOTE]

Thanks for your reply! Imaging with ultrasound did show the increases. Both sides are affected, though the left is more pronounced and also has more pain associated with it.

I worked on posture throughout my time in PT (1 year), but we had difficulty tackling the posture issue because of the synergy between my lower back pain (i.e. need to sit up straight) and my shoulder pain (pronounced if my shoulders and back aren't rounded forward, and couldn't get the tendons in the shoulder area to relax naturally to the normal position). I still do scapular stabilizations exercises, various back stretches, and tons of shoulder strengthening exercises to at least try to mitigate a bit of the pain.

I also had two massage sessions as a gift and those were wonderful! I have a lot of aches and soreness under my scapula and in my rib areas on my back, my neck is constantly stiff and sore to touch, etc. But, without the funds to really dedicate to going consistently, I tried to work on things myself. A foam roller helps some with the back and upper thoracic area, but the front shoulder area is harder to get to in general.

Brad

Brad, thanks for sharing your story, and welcome to the forum. First, you are not alone, and u r part of this family. As a man dealing with TOS for twenty years, I know what u r going through. The numerous doctors, test, and people not believing our story. I'm heading for my third surgery in Dec, so I know.
Second thing, keep fighting. U have too much to live for to give up. I've been there with the suicide thoughts, but with the LORD help, I got through it and will continue to get through it. If u could, stop focusing so much on the pain, and turn it to into power. If u don't, it will get the best of u.

Third, try and work on your posture. The doctor that's doing my third surgery, told me to sit and walk upright. Also when u r walking, put ur arms down, and move them back and forth. This opens your scalene muscles. Also, make sure the doctors u r dealing with knows what they are talking about. I've had so many doctors that didn't know anything, only guessing. Don't let this linger as long as I have, it will get worse. But it wasn't me that caused my 20 years of TOS. If u think surgery is best, GO FOR IT. U need to get this resolved.

Thanks again for sharing, and we look forward in hearing about your surgeries and other stories. If u have a chance, read about my story with TOS for 20yrs. If u need to someone to talk to, feel free to send me a PM. It is always good to get this off your mind.

God bless, and keep fighting!!!!

Brad,

I'm sorry to read all you're going through. It's been ovewhelming for me and I'm 51, with some resources. I can't imagine going through this in my 20s, while getting a doctorate.

The main issue, if you are pursuing surgery, is to get yourself to the most experienced, most expert surgeon you can find and afford. It really matters who does this surgery. The other thing that jumps out at me from your post is how much excercise you are doing. For many of us with TOS, that kind of exercising can make symptoms worse. TOS does not present the usual "no pain, no gain" dilemna. If your pain is increasing due to an activity, it's a good thing to curtail it.

I had surgery 8.5 years ago and it was unsuccessful (so put my experience in perspective), but it took me 2 months before I could function at all. I would say a recovery of one month is quite ambitious, especially if you are going right back into school at the end of that month.

I understand how taxing this experience is -- physically, emotionally, psychologically. The chronicity of the pain is hard to take and impossible to plan for. I'm glad you are in a better place now than you were a few years ago.


Take care and I will be sending good wishes your way.

Kelly

When is your surgery?

brad,
you sound like a survivor.
i don't think one month is going to do it. many doc told me the same thing. i went to donahue at mgh who told me 3months. i didn't like the sound of that.
well i am 3 mo post op w/ dr d and yes, it takes a long time to heal.
my surgery went very well - and even so it will be a year b4 i know if it is working or not.
i hear the armpit is harder to get to everything.
have u done pt? look up inst of physical art for rib mobilization pts.
mark

Hi Brad! Welcome to the forum! I cannot tell you how nice (sorry) it is to meet another person who Doctors didn't take seriously! I have A/V tos and had two completely successful surgeries (left and right side rib resection/scalenectomy) in '11 and aug of this year. I was previously looked at though, prior to meeting my excellent surgeon, that it was "impossible" for me to have this condition, it "must" be something else, I "looked" too healthy/fine/in shape, and "maybe" I was having an "allergic reaction" to lotion and that's why my arms/hands were turning maroon and swelling. Noooo, I had severe compression of my subclavian veins and arteries bilaterally. All fixed now though! ;)

As far as the surgery method, every surgeon usually has their own tried and true technique. Most boils down to how they have been trained, and how they feel they can get the best results for the patient. My surgeon uses the Transax technique as well, he felt that it gave him better access to the rib and scalenes while being able to work around and avoid the nerves easier. I appreciated his concerned effort, and it paid off big time!! Good luck in your surgery/journey! And congrats on your studies thus far!

Hi all,

Thanks for the best wishes and support. I'm still hopeful that my surgery will go well and I should know more in a few weeks after I have a pre-op with my doctors. I have also been looking into some of the PT exercises that you all have suggested, thanks!

I like hearing your stories. Of course, I especially like the success stories, but it's also really nice to hear about longer recoveries and failures. Doctors seem to be so surprised or new to TOS, in many instances, that they don't want to give any projections (hopeful or not). Honestly, I think the first eight doctors didn't even want to talk about TOS or surgery until I got nth opinions from more doctors. By the time you get to the ninth or tenth doc, you don't even know what to ask.

Good to hear from everyone, thank you!

can you send me a pm, tried to contact you directly.

Hi there. I'm an 18 year old guy who just had a transaxillary first rib resection just a week ago. I was diagnosed with Neurogenic TOS and was told I had a small tear on my anterior scalene muscle. My general symptoms were constant tense shoulder and neck muscles, a toothache throb feeling that wouldn't go away, and sharp pain behind the shoulder blade. After a year of these symptoms and quitting weight lifting, it went from constant muscle tightness and pain behind the shoulder blade to more of a nagging extremely weak feeling. As atrophy set in popping was a constant and lifting things caused pain. I opted to get a first rib resection and I wouldn't have it any other way. The procedure was done at Rush University Medical Center in Chicago, which was an outstanding hospital. My surgeon used Video Assisted technology (VATS) that left me with only a two inch scar in my armpit. I stayed overnight and went home the next day late afternoon. The pain was no worse than anything I have already suffered through, the main culprits being numbness and a simple pain radiating slightly behind the scapula itself. Within the first few days I experienced stiffness and slight pain at the elbow and wrist, which seems to be from the inflamed ulnar nerve. Weakness was also more prominent after surgery. All the tenseness that was in my left trap was completely gone, leaving me in awe at how soft and stress free it was. After an entire week has passed, I find the only annoyance is the swelling and the fact that the muscles are still extremely week in the arm. Every now and again my wrist has a small tinge of pain to it but nothing compared to the pain of TOS itself. With the exception of popping, I still have most full range of motion. My original cause of TOS was a fractured first rib that would not heal, and I'm lucky enough to say I cannot even tell the rib is gone. As swelling goes down and the healing is continuing, I'm feeling more and more back to normal, back to a happy full life. Although your symptoms are a lot more severe, I thought you should hear my story. Best of luck, no one should have to go through what we did.

from emla
 

Dear Heybro,

I too am seeing Dr. Donahue at MGH and he recommends surgery. This is after years of increasingly debilitating symptoms and going through what so many with TOS experience: a parade of doctors, numerous misdiagnoses, failed treatments, chiropractors, massage therapists, acupuncturists, physical therapists, meds, alternative treatment . . . etc. I'm wondering how you're doing. Surgery terrifies me, but I don't think I have many other options at this point.

Emla

Emla,
You have Nothing To Worry About. That is what I wish I could say to myself if I were talking to myself before surgery. MGH, Dr. Donahue, are miracles in the flesh. You have nothing to worry about at all. Surgery is nothing compared to what we have already gone through - HONEST! Expect to sleep a lot and go easy. The worse is over; I promise.

thx
 

Thanks for the reassurance Heybro. Also for all of your detailed, informative posts which are very helpful. I hope you're doing well and feeling better with each day. Dr. Donahue does indeed seem to be an extraordinary doctor; thoughtful, generous with his time, clearly one of the best in this field, and none of the ego bs or cluelessness I've encountered with so many other docs (and I've seen dozens over the last 4 yrs trying to get to the bottom of these bizarre symptoms). Did Dr. D recommend post surgery PT? (apologies if you covered this elsewhere - still getting the hang of how NeuroTalk works).

face pain
 

Has the toothache feeling resolved or eased up at all since surgery? I have constant headaches and pain in the jaw area (mainly right side where TOS is worse). I keep these symptoms under some control with trigger point work (using the Clair Davies Trigger Point Therapy Workbook) but the pain never fully goes away.

- emla

so sorry about your ordeal
 

Hi Brad,

My heart goes out to you and I'm so sorry to hear about your suffering with this horrendous condition. I completely relate to the exhaustion of dealing with TOS. At this point, I'm too tired and depressed by the whole thing to detail my symptoms here (they are pretty much the same as most TOS folks on this site) or talk about this any more with friends/family. I was a serious musician and can no longer play (playing probably largely causing to this condition). My day job is an office job, lots of typing, and as you can imagine, that's not helping matters. I'm weighing the surgery option now with Dr. Donahue at MGH (clearly, one of the top docs in this field). After years of wondering what in the world is wrong with me, dealing with worsening symptoms, being shuffled from one clueless doc to another, it's a relief to finally have a diagnosis that makes sense. Perhaps of help to you, look up a paper titled "Thoracic outlet syndrome: a controversial clinical condition. Part 2: non-surgical and surgical management." Troy L. Hooper is the first author. I found that the "Cyriax release maneuver" provides some relief. I've been to many PTs, but sadly it seems few are versed in treating TOS. One however who sees many MLB pitchers tried some of the techniques detailed in the Hooper paper, namely the first rib mobilization. A few times this provided a few days relief in arms and hands. Other times it caused severe flare-ups. I hate taking meds to treat this b/c they don't fix the problem, but I've been taking a low dose of Tramadol for a while. I'm generally intolerant to meds, but this one I can tolerate. It also has a mood elevating effect (at least for me). 150 - 200 mg/day is considered a normal dose, but just 25 mg/day as needed helps me considerably with pain (I'm around 105 lbs). Anyway, I thought I'd share this info in case it's helpful.

Wishing you the best,
Emla

Brad-

You are not alone in the things you've experienced. Best wishes for your surgery. I had bilateral transaxillary rib resections 8 months apart. each time, I returned to work after four weeks. I was not without pain by any means, but it helped to be moving and I eased back in. I had no complications, no chest tubes from either surgery.

I also went into surgery thinking it was not going to help. I was just desperate. I had a top TOS surgeon tell me I did not have it, that surgery wouldn't help. I remember waking up and my husband telling me what the surgeon had said, that my nerves, arteries and veins were all severely compressed even with my arm down, and they were able to remove a large enough portion of the rib. The first thing my surgeon said to me on my follow up was, "you were in a lot of pain". I am sure many of the people on this forum would understand how validating this was to hear from a doctor.

I am about eight months out from my second surgery, and while I still struggle daily with pain, my worst days now are better than my best days before. I simply didn't think it was possible to be this much better and I am so grateful to feel stronger each day, even if it is in small increments. Keep persevering and advocating for yourself, and find doctors to help you resolve your issues.

Good luck.

PT is something you do before surgery - to try to avoid surgery, not after.

Thanks for your story. glad you are doing well. May I ask who your surgeon was? Did you consider seeking out someone more well known as a TOS expert?

thx. I've seen mention of folks going to PT post surgery and figured it was for necessary rehab.

Sorry, but I disagree with heybro on that one. I had surgery 22 years ago and have been miserable ever since. However, in last 3 1/2 years I have improved greatly, by doing joint mobility exercises, self-myofascial release, and vacuum cupping. I never had the right type of physical therapy following my surgery. In my experience, the right type of therapy, even years after surgery, can make a huge difference.

I also have to chime in on this one.... and I tend to agree moreso with Coop.

At the very least -- range of motion (ROM) exercises should to be done daily as soon as possible post surgery.

I haven't had anything as serious as the TOS surgery, but I have had several upper extremity nerve decompressions. At each one - I was told to get back to normal activity as quickly as possible and start ROM exericises and nerve gliding ASAP. You want to be using/moving your muscles and nerves through their full range of motion while the scar tissue is forming in your body. This way, the scar tissues forms around your active, moving body -- and is less likely to 'clamp' down on key structures.

Its tough balance to find -- as you don't want to do 'too much' and cause inflammation (and associated scarring) but you also don't want to 'over-rest' and let you body lay dormant for too long.

Again, I haven't had TOS surgery and I recognize there are a number of issues specific to the nature of this surgery. I suggest you do further research to figure the best type of PT and the appropriate timing of PT -- post surgery for TOS.

I just wanted to clarify.

As far as I know, Range of Motion done yourself under the instruction of your doctor should be done after surgery yes. Physical therapy after surgery for the continued treatment of TOS may be helpful, yes of course.

But, do you need physical therapy in response to the surgery itself? No, as far as I know.

Further, no physical therapy should be done with someone that has not treated TOS before. Finding a good PT that knows TOS is key regardless of when the PT is done.

Heybro,

How is your post-surgery recovery going?

I have the same opinion as Heybro- I was given ROM exercises only, no PT. But I didn't need PT either, I was in great health, great physical shape, no muscle wasting, and I didn't have nerve involvement. Every patient is different, their surgery/complications/condition of TOS is also different. I had my left side rib resection and scalenectomy done in '11 and right side done this last aug. No PT before or after, and I'm doing wonderful.

Which doctor at Hershey
 

We are looking for a dr. at Hershey that treats TOS..do you mind telling me who you are seeing?

Very good thank you! Slow but sure!

So glad to hear this!

Hi everyone!!

I have been looking at this support group for several years but have never posted. However, I've recently found a way out of the TOS nightmare, and I decided to share my story to try to help someone else.

I first started having symptoms about 6 years ago, while I was writing my PhD thesis. I had excruciating upper back pain whenever I worked on the computer. I managed to finish and got a new job as a scientist at a prestigious research lab, where I struggled through the first year with horrible pain every day. I saw 5 different specialists and was told that it was either a disk problem (seen on an MRI) or muscle strain... I went to 3 different PT clinics for 6 months to no avail. The only thing that seemed to help somewhat was deep tissue massage. Finally, I was a neurologist who gave me trigger point injections, and my pain eased up a bit.

I had a good 3 months or so, and then I suddenly started having hand pain while driving and typing. It got worse over the course of a few weeks, and I was back at the dr. This time I had nerve conduction tests (which were normal) and was checked out for a possible rheumatological condition, but my bloodwork was also normal. I found a hand therapy clinic and went there for several months, made all the ergonomic changes at work, etc, but not much helped. I was referred to Dr Jordan in Santa Monica and he diagnosed TOS. He said my scalene muscles were extremely tight and that i was a typical patient... Tall/thin with droopy shoulders/poor posture and long neck. He recommended a nerve block, which I held off on at that point. I started neuromuscular/trigger point therapy, kept doing my PT, and tried to type less, and gradually my hand pain got better/more manageable, but was still there. Then I got pregnant, and my symptoms went away miraculously while I was pregnant. They came back 3-fold afterwards, however. Back to dr jordan, and this time I did the nerve block, which was somewhat inconclusive in terms of helping my pain. However, he said that my muscles were extremely spastic and that I definitely had TOS and would benefit from botox. I shelled out $5k for botox injections and they didn't help at all.

Fast forward 6 months, and I was almost completely disabled. I could no longer type or work at the computer at all and used dictation software for whatever little I did. I was on disability leave from work. I spent most of the day lying on the floor trying to manage symptoms. I was unable to care for my son, drive, or do any type of work around the house. For almost a year I went to PT/hand rehab twice a week. I did active release technique as well (which helped a bit ... More than PT). I was scared and depressed... I figured i would have to change careers. I had endless drs appointments... Several neurologists, rheumatologists, chiropractors, physiatrists, counseling/therapy, PT, hand rehab, OT... And on and on. Sound familiar?

I spent a good chunk of each day researching this condition online. Somehow I managed to come across the work of dr John Sarno, a (retired) physician at NYU who claimed extraordinary success rates for chronic back and limb pain, including RSIs and TOS. I read more and more online, and his theories of the connection between stress and pain resonated with me... I read his books a few months ago and had the most remarkable experience of my life. Literally, within less than a week of reading his books the agonizing back pain that had been my constant companion for several years had dissapated, and within several weeks my hand pain was gone. I now type as much as I want, in whatever "bad" posture I want to, with no pain. I lift my son, drive, blow dry my hair, and basically do absolutely everything I want to with no pain. I have completely stopped all PT/massage, etc. I know this sounds too good to be true. I wouldn't believe it if it hadn't happened to me.

Basically, dr Sarno says that your brain is shunting off bloodflow to various parts of your body due to a stress response, which is causing your pain (not totally inconsistent with standard TOS theory, except that it is an emotional response, and not a mechanical problem at all!) Once you realize this you can counteract it. This tends to happen more to highly driven, perfectionistic, ambitious people who tend to repress neagtive emotions. In retrospect, it was initiated for me by the stress of graduating, starting a new job, and some marital issues. Once it starts, it can go on for years, perpetuated by fear and pain, and completely take over your life, until you realize the emotional root of the problem.

Literally thousands of people have stories like mine. People who've had pain for decades, and have been bedridden even, have made astounding recoveries. He's written several books, spoken to congress and been on 20/20. **

Dr. Sarno
 

Literally thousands of people have stories like mine. People who've had pain for decades, and have been bedridden even, have made astounding recoveries. He's written several books, spoken to congress and been on 20/20. **[/QUOTE]


There may well be (probably is) a psychological component to many cases of TOS - the workings of pain and the mind body connection are simply not fully understood. But I find Dr. Sarno's reasoning - essentially that "it's all in your head" - limiting and paternalistic. The notion that TOS symptoms/pain is the brain's way of dealing with compulsiveness, perfectionism, anger (Dr. S's theory), does not apply to me. But we are all differently constituted and Dr. S's theory may resonate with others. I'm glad it helped you.

There may well be (probably is) a psychological component to many cases of TOS - the workings of pain and the mind body connection are simply not fully understood. But I find Dr. Sarno's reasoning - essentially that "it's all in your head" - limiting and paternalistic. The notion that TOS symptoms/pain is the brain's way of dealing with compulsiveness, perfectionism, anger (Dr. S's theory), does not apply to me. But we are all differently constituted and Dr. S's theory may resonate with others. I'm glad it helped you.[/QUOTE]

Well... most people will reject the notion that there is an emotional root to their pain, which is totally understandable. In fact, I did for several years. In retrospect, I had seen and heard about Dr Sarno's work several times on various postings, etc., but skipped over or ignored them. Actually, i saw an osteopath 5 years ago when I started having back pain who very, very adamantly insisted that I consider the emotional aspect of my pain and read dr Sarno's work, but I completely ignored that suggestion in favor of the "physical" remedies he suggested: TENS (didn't help), neuromuscular therapy (helped temporarily), accupuncture (never tried this), PT (didn't help), MRI... which showed a small disk herniation (in retrospect, my pain got much worse after seeing that MRI). In fact, I was really insulted and never went back to him. I figured he was suggesting I was overemotional/hysterical because I was a woman.

Please consider to yourself whether there are any inconsistencies/holes in the structural theory for your pain: for example, I had terrible pain in my back as well, which Dr. Jordan said was a separate condition and not part of the TOS(?) I also had occasional low back/SI joint pain and had a history of stomach problems. I tended to have pain in one place at a time: either hands or back, almost never both. Why would this be??

I will get off my bandwagon now, but if this has sparked some interest for any of you, please look online for other people's recovery stories (there are plenty) and read about tension myositis syndrome, which Dr. Sarno contends is the basis for most chronic pain conditions.

I have read Sarno's book 3 times. It didn't work. I think many people suffering daily chronic pain get to a point where they are willing to accept any possible theory and do whatever it takes --- just to stop the pain and MOVE ON.

While Sarno may have helped some people, I thnk he has hurt many *many* more.

It's been over a year since my surgery. There's been a lot of ups and downs. I do have pain free days, however some wasting occured in my wrist (carpi ulnaris), small muscles of the hand (dorsal interossei), and medial tricep. I've still been working as an electrician and I can still perform my work, overhead included. I have a hard mass in my neck which could contribute to some of the permanent symptoms. Hypersensitivity in the tricep comes and goes, but lately it has been minimal.

The worst of the pain is in my wrist now and again, but fortunately those symptoms seem to be easing up as time progresses. Now sadly I've been experiencing occasional nagging symptoms on my right hand, wrist, and shoulder. Nothing as bad as the other side, although hopefully it does not worsen. Will be seeing a doctor soon. Thought the TOS was caused by my fractured rib, thinking the new side is cervical disc problems and arthritis. My surgeon was Doctor William Warren at Rush university. I believe the surgery was a success. Not perfect, but I am a lot better. Hoping the symptoms on my other side aren't a product of the surgery. I hope you all are improving! Be strong...it's not always easy

Hi Dom9889,
I also have a fractured first rib on the left side which likely has something to do with my TOS symptoms. But I have pain on both sides so I tend to think that rib fracture is a consequence, not a cause.

BTW, on dr. Sarno's books. I read three of them and they did nothing for me. I found his ideas arbitrary and far-fetched (just like the Freud's theory they are based on). Supposedly the subconscious mind cuts off blood supply in an area where a physical abnormality exists (like a broken rib or a herniated disc) in response to some emotional issues. I find it not plausible that the subconscious mind has knowledge of anatomy which the conscious mind does not.

I don't doubt that his approach helped some people, but don't think it will help most. And I suppose the reason it works is much simpler.
People habitually tense their muscles in response to daily stress. If one can create an emotional stress which overpowers the daily stress, it may distract the brain and release tension. But I don't see how this can help with structural or postural issues.

wrong thread

Sympathetic nervous system (http://en.wikipedia.org/wiki/Sympathetic_nervous_system). Overexcited means its always leading to stressed muscles. Slow and steady breathing is key to relaxing the SNS.
Stressed muscles tense up and fix the posture in stressful poses which in turn stress/activate certain muscles. Shallow breathing further stresses the wrong muscles (accessory musles) which impinge on the brachial plexus.

Sarno has addressed the mental aspects of an issue. But the physical aspects need work as well. Both go hand in hand from what I have been told.