Possible factors & causes in getting TOS
 

I thought we should make a list of as many relative factors or causes of acquiring TOS.


Prior Whiplash, Motor Vehicle Accident
*Upper body Injuries*
Falls, Hits,
Sports Injury
Repetitive Strain Injuries
Head /Shoulders - forward, hunched, jutting postures
Prior Collarbone Injuries
Tilted body alignment - Head/shoulders/hips uneven
Intense/long hours @ static desk work, computers

I got TOS from...
 

Believe it or not my TOS was aquired from crocheting. Several years ago I decided to crochet afghans for several family members. My family loved them, but I am still paying for it now!

poor posture...
 

I think set me up from the beginning. I'm small framed and constant poor posture and a relatively sedentary lifestyle didn't help me at all.

Of course years as a bedside nurse and 6.5 yrs of computer work didn't help.

And this goes along with poor posture but I always held any tension in my shoulders therefore probably setting up that whole scalene muscle thing.

cause of my tos
 

Tell Her What She's Won, Bob!
 

well, since mine is a case of true neurogenic TOS it's difficult to say. as some of you know, it hit me while i was still in college and i had a decades-long "gap" between onset and dx, but when i presented several possibilities to dr. ahn 28 years after onset of sx (difficult pregnancy, carrying toddler around, faux pas in jazz dance class, poring over text books or lugging around same), he suspected my pregnancy more than anything else as the trigger for the severe sx (the "cause" being underlying congenital anatomical anomalies major enough to not only have kept me in high pain for most of my adult life but to have caused gilliat-sumner hand; the hand atrophy had been clearly noticeable since the mid-1980's).

i remember reading in the medical literature after that first or second encounter with the great sam ahn, that pregnancy can be enough of an insult to the body to set off the TOS beast in some women (well, if it set off TOS in any men, i suppose you'd really have something to write about!). so hmmm. seems to me then, sam was playing it safe by saying that to me... the old tried and true, as it were. didn't want to hurt himself breaking new ground or anything... nor move too swift nor talk too wise, in my case anyhow. god forbid these guys should tailor-make their approach to any one of us TOS'ers. does anyone else find that infuriating? fortunately, i had forewarned my lovely daughter, chelsea, that he might say that, as she was with me on that visit.

we're neither catholic nor jewish, but we WASP's can do guilt just as well as anyone else; she was horrified to think that she was the cause of her mommy's great anguish and this young woman has born witness to it, let me tell you guys. chels does not remember a day when her mom was NOT in pain. TOS has stolen so much from her! it makes me so angry. she could have had brothers and sisters, for starters... i love babies; i love children - but if i couldn't even pick her up anymore, how was i going to have more? i never did. OK, sorry, i'm getting off topic here. anyway, of course after getting out of ahn's office i immediately put my TOS arms around her and told her i would go through it all over again, 100 times if necessary, just to have one day with her. i love her so much! and of course it goes without saying that none of this is her fault. i am back to my idea of a charm school for TOS surgeons now...

but i have my own theory on TOS etiology as well, iconoclast that i am.

ready, kidz? OK, here it is: sins of a past life.


yes, i'll go with that.

makes about as much sense to me as anything else.

go ahead and make fun of me, you guys...:Sigh:

alison

P.S. there've been lots of fender-benders (i live in LA), an elevator accident, and a high-stress job between then and now in which i'm sure i reinjured myself on a daily basis between heavy computer use and almost nonstop telephone nonsense. all nails in the coffin, my friends, nails in the coffin of my TOS ****. but for purposes of answering the question i tried to limit myself to the very onset of my TOS, which was waaaaay back in the '70's before most of you were even born probably! shut up! leave this old woman alone. and why can't you access emoticons on an edit, what's up with that i wonder? these are the questions i ponder, folks...

yoga :(

crow pose-balancing all your weight on your hands and tucking your knees onto your elbows in the air

also did a lot of computer work and not very good posture

Dentnal Hygiene.
Static posture for hours at a time sitting with my held tilted to the right
holding my elbows up and out for hours to hold the dental mirror and instruments, reaching for the overhead light and Cheap dentist who don't want to invest in their practice to get updated equipment. Unforgiving patients who can't seem to recline in the chair all the way but yet they lay down to go to sleep at night..go figure. I started rescheduling them with someone else if they wouldn't compromise. With the exception of elderly, pregnant, gastric and physicallyinjured or handicapped of course but it took me after the 4th and 5th surgery to figure that out.

Mine would be caused from congenitail cervical ribs. Born with it and live with it as painful as it has been.

Phoebe
 

Phoebe,
How is this possible?:)

" and a relatively sedentary lifestyle didn't help me at all."

You may have had a sedentary lifestyle at home because you worked your %^&* off at work as a bedside nurse.:wink:

Nurse and sedentary lifestyle in my opinion is not possible!:D

what causes TOS?
 

anything that will cause scapular instability, e.g. wry neck + holding arms infront of body for long periods (musician, typist, hairdresser, awning installer) + changed breathing (pregnant, reaction to medication, putting on weight causing pressure on diaphragm) + work hardening program, truncal strenghening program+laying on back for extended periods.
\
if the person gets a wry neck and doesnt have an exacerbating factor they are likely to recover. if there is an exacerbating factor that doesnt allow the scapular instability to resolve, it is a slippery slope into the abyss. regards towelhorse

Sedentary
 

Yes Martha,

At work I did work my @#$% off and then some, and sometimes as you know, you run constantly for 12 hours. And yes, the type of work I did is back breaking. I was sedentary that last 6+ yrs., but that was where the repetitive stress came in bigtime - telephone triage - bad posture, bad ergonomics, etc. etc. I sometimes give myself credit for only the bad things I've done to by body, ie poor posture, leaning over that bed in not the perfect position, rather than the good things I did for people when I was in that position.

I tend to be a little too self critical at times. :) phoebe

And,
 

Now you've got me to thinking. Yes, now I feel like ranting. The working conditions for nurses are pretty horrible in general, and I'll probably get agreement from most of the nurses here. You work as fast, as thoroughly, as safely and as therapeutically as you can but there is simply never enough time, I can't count the hours I've put in getting all the documentation down, after the shift has ended. And, as you know, you have to reach up to set that monitor, find enough plug ins - move stuff all the time so you can get to it. Sometimes I felt more like a mechanic, up and down and kneeling and craning your neck to see something.

I went through horrible anger about 10-12 yrs. ago, when they were actively and not secretly, trying to get rid of all experienced nurses for monetary reasons, hiring only new grads (not that there is anything wrong with a new grad, we've all been there). But, when I officially retired almost 4 yrs. ago, they were beginning to see the error of their ways.

And I was just lucky enough to be of retirement age when I really knew for certain I was "totally messed up musculoskeltally".

Wow, didn't mean to rant, but it felt good. :) phoebe

yep, i feel a rant coming...
 

And now they think there is a nursing shortage!

HA!!! IMHO there are plenty of nurses but they are not working in the nursing field.

They have been driven off because of terrible working conditions.

Yes, I saw the charge nurse on the floor i worked on for 5 years laid off (yes, there were many lay offs about 15 years ago) conveniently at 29 years so she wouldn't get her 30 years in!

Then there is the 400 lb. patient (no offense to large people) that you are expected to move with the help of a very tiny nurse's aid that barely can speak English (again no offense) No mechanical lifts.

We pushed heavy beds with the patients in them, monitors, heavy sleep chairs you name it we moved it or lifted it.Trying the entire time not to trip over the visitors who have come to visit their friend, they don't know their last name but we have to take the time to try to find this 'friend' in a 600 bed hospital.

When I first got out of nursing school(1979-yes, I'm dating myself here) they taught us NOT to wear gloves when you were changing the patient's colostomy bag or cleaned up feces because it would cause the patient to think you thought their colostomy was offensive.(EEYOO!)

It took the aids epidemic for the hospital to finally give the nurses gloves to protect themselves.

I gave the hospital the best years of my life wading through the blood and the ***** to have them completely turn their back on me when I was injured as a patient in their OR. Not only did they ignore me, they sent me a bill for $600.00 to pay the balance of a bill for a surgery where I was permanently disabled with a brachial plexus stretch injury]caused by the doctor's error

They said if I didn't pay they would send me to collections!:mad:

I also gave the hospital sooo much of my time for free by coming in early to get organized and staying late to document correctly.

It does feel good to rant.:rolleyes:

Oh boy,
 

I could go on and on. And I, like you, enjoyed nursing in spite of the drawbacks.

But, now lets say nursing probably caused 80% of my problems and the posture, etc. is what made me become symptomatic.

I graduated in 76, and you're right, no universal precautions, we always recapped the needles (LOTS of needle sticks) - ok enough - I feel better now and I didn't even know I needed it. :) phoebe

oh our poor nurses of north america
 

I am not agesist, sexist, racist or in any way intollerant but as a nurse it was a saying in jest of course was that if you grew it you move it! We took six nurses to move up a 500lb pt who was dying!!! I was injured on the job with my arm under a 180lb pt's arm and lifted with another....but was injured as the bathroom was too small and I took all the wgt of the pt due to the other person having the sink in the way of her ability to lift this poor dying patient back to her bed!!


so job....lifting in the wrong way but he only one available.....thanks to all who were and are nurses!

love and hugs
Victoria Gibb RN

I just want to jump in here and say thank you to ALL nurses on here and everywhere. I've had some wonderful nurses both while I had outpatient surgery and was in the hospital. They're the ones who are on top of things and know when their patients aren't doing so well- not the doctors- because they see alot more of their patients than the drs. do....Too bad some drs. don't pay more attention to what nurses tell them. And hospitals are like every other business nowadays- trying to cut back and get by with fewer nurses and the nurses are busting their a%#@^ and the patients suffer because the nurses aren't able to be there as quickly when needed.

many here have lost rewarding careers...
 

Red,
 

It's your profession that now is now a blessing to all of us. Oh, a massage. I do that ball on the wall self massage, and, IF I don't get to aggressive, which I seem to do alot, it helps me so much.

I thought of something else, and then I'll really shut up. My father, after retiring as a minister worked as a volunteer in a hospital for 20 years in the acct. dept. (the field he got his first degree in). He worked mon-fri 8-5, only taking off for vacations and drs. appts. He was hospitalized here, one of three hospitals he was to be a patient in over a period of 10 days before he died. They had offered him a paid job which he had declined, wanting to take off when he wanted or needed to. Their hosp. bill was the first to arrive, and the first to send a collection notice (because of course we couldn't pay it because it was then in the lawyer's hands).

Ok, I really am done now. Sorry to have jumped on this thread so heavily.

:) phoebe

what wonderful volunteer service
 

I think it is any employer:( unless you happened to have worked for a very small company or business. Once you are not there anymore for whatever reason they forget about you. Big business just keeps on keeping on.

I don't blame my former coworkers or my employer - if the situation were reversed - I wouldn't have time to keep in contact with someone that left work because my work & life would be plenty hectic and busy.

A lot of us gave too much of ourselves to a job :( and here we are.
Darn type A behavior!!:mad:

Phoebe,
You're right about those massages! It's been a long time since I've had one myself but all this talk about them has reminded me that I need to make an appt. I know what everyone is talking about here- I haven't been able to do my job for several years either.

Causes for TOS
 

I`ve got arterial TOS after an accident and the doctors say that I have the ideal thorax to get it - maybe the accident was the "acceleration" of TOS.

Just wanted to add this!
Bye Barbara

Hello; It was 18 years of hairdressing that caused tos. Especially the last 3 years working in a very busy shop (sweat shop). I was in the same position for 8 or 9 hours a day, arms raised, neck forward, almost like an assembly line, very poor posture. Lots and Lots of repetition with my hands and arms.

REPETITIVE computer and desk work
Working hundreds of OT hours in a very noisy and unergonomic work area.
CT or Cumulative Trama/RSI Repetitive Strain Injury

causes of tos
 

Ocgirl; Thanks this is. What great information.:)