NeuroTalk Support Groups - TOS versus pinched nerve in the neck

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- - TOS versus pinched nerve in the neck (https://www.neurotalk.org/thoracic-outlet-syndrome/15546-tos-versus-pinched-nerve-neck.html)

TOS versus pinched nerve in the neck

My doctors are in disagreement about whether my nerves are being compressed in my spine or in my brachial plexus. I'm wondering if anyone else has had a similar dilemma?? And, if so, were the doctors able to resolve it? How?

A number of doctors have read my cervical MRI's and have not found any major disk problems. However I do have a an abnormal EMG showing re-innervation in the muscles supplied by my C7 nerve root.

The main reason I ask is because I am wondering whether to try getting a cervical epidural to see if that relieves my pain. I would love to hear anyone's thoughts on this particular treatment also.

Many thanks for all thoughts!

Sorry, if I do not understand your exact question, but I assume they are talking about doing a never block at C7. Nerev blocks are an excellent way of ruling factor and if it helps out than this may be the root of the problem. Emg's are not always the best indicator of the problem, though it is a good starting place. I have had Scalene, pectoral and trapezious blocks which according to 3 of the doctors I see said that these are a positive indicator since they rmoved the pain totally for a short period of time. Along with my EMG which show brachial disorders therefore it can be concluded as TOS. I also have CRPS/RSD... this proven by pain, swelling and heightened sensory perception. This includes the rubbing of my clothed actually hurts, cold on my hands makes my skin *BURN* feels like it is on fire right down to the bone and now with my nerevs being in a hay-wire statemy right big toe up the arch of my foot. I hope that I was able to answer somwe of you questions.... though sure there will be others around to help!

I have left side herniations on the C5/6/7/8, right side TOS primary.
I had a severe symptom of cervogenic headaches 24/7. A knot at the base of my skull. The neuro diagx TOS, I had an EMG also, and the brachial nerve stretch injury. The brachial nerves bundle travel from teh cervical spine, C5/6/7/8 t/1; they leave the spine travel across the area in the trapizus, behind the collar bone and infront of the first rib, down the arm and into the hands and fingers. Along way to travel for one long nerve cell, about three feet.

Anywhere along there can be a compression or impingement, or sick nerve...ie)injured. Any injury to the nerve can cause multiple level symptoms. Ex: the shoulder, the elbow, wriste. The whole nerve is sick, sick nerves do not heal if injured severely they can have less compression, remove the compression, or alter the path, as in ulnar nerve surgery.

But, my point is that I had cervical ESI at the C5, the doctor aimed the injection to cover my knot in the skull, traps and arms. I had a fluoroscope used, I did not take anesthsia, except the local. But when I went in I had a flare in the headache, severe, it was coming up from the spot that felt like a butcher knife in my back...into the skull.
After the injection, immediately I had relief! I had previous injections that helped the arm pain and hand, but this one covered so much more and I never had that 24/7 pain again. No ER visits, no days in bed, a life back. Another police officer in an accident as had the same injection, places similarly and he had great help too.

I felt like I was blowing up like a balloon, lots of pressure no pain, but if I get another one if I need it, I will ask for versed or something. It was the discomfort, not pain that bothered me. I also have these for the lumbar too.
I never needed another cervical one since this last one a few years ago.

So while getting them for a herniation, I actually had better nerve pain relief of the TOS from them. The nerves really calmed down. I have tuned up with trigger points in the myofascial trigger points in trap and rhomboid areas, Oh, and lumbar. BUT, ESI was the best, not the first, the second one better, by the third I was kicking the worse symptoms I had.

The doctor used depo medrol and I needed a driver.
Many doctors order the ESI for cervical diagx, but for TOS I found the greatest relief.
Di

Another thought by me is that an expert/advanced PT- or even a expert chiro should be able to do some postional , traction , compression tests to verify if the sx are from the c spine vs the TOS.

At least that's what 2 PTs and the chiro did - none of the MDs did any "hands on" testing like that.

Have you had any "hands on" type of thorough evaluation?

a good one will take approx 1 hour or so.
Positional testing is very helpful indicator {but not a conclusive test, just good to have it verified} - not just

Hi! I agree with Jo that often a PT can find something with a thorough exam that a doc won't find in the office. My therapist knew I had neck issues long before I ever even had an MRI.

However, it is difficult to differentiate c-spine nerve issues with bp nerve issues...last spring I saw a neurosurgeon for a second opinion re: TOS surgery; we decided against the TOS surgery, but did go ahead with a cervical fusion C5-7. He said to me, "Maybe you don't even have TOS...maybe it's all coming from your neck." This was after two years of many doctors agreeing on the TOS dx, but this doc is a top-notch NS. Dr. Sanders even agreed that I should try the disk surgery first...after unsuccessfully attempting to get relief from about every possible injection. The surgery relieved a lot of the neck spasms I was having, which were getting much worse, as well as the cervicogenic headaches, but did NOT help with TOS symptoms at all.

I say this to show that even experts in the field can't always tell what's causing what. It really wasn't until after the surgery that I could know for sure the TOS was not cervical radiculopathy. I'm not sorry I had the fusion at all, because my neck is so much better...but, unfortunately, the TOS didn't go away. At least I don't have the neck pain along with the TOS anymore!

I think the ESI may be a reasonable treatment to try, as it certainly does help some people and is much less invasive than any of the surgeries. I hope you can find some answers, and your pain can be relieved!

Donna