first p/t--is this norm?
 

Last week, EMG showed carpal tunnel, physiatrist also put TOS as diagnosis, though all she found was CP. I def has more pain in the shoulder, neck, underarm than even CP area.
So, I had my first p/t today and he had me lie down on back, breath in, while he pressed downward on my first rib--he said he wasn't trying to move it, just loosen. On both sides, he had me breath in and then out as he push down--hard to explain, hope some of you understand. It didn't hurt, just felt like a strong stretch. Is that normal?
I am having the usual flare up that I get by every afternoon--behind right shoulder blade, under arm burn, some front of shoulder burn, back of upper arm. I also get this weird neck thing all around that feelis like fire ants crawling.
OK, just trying to see if I'm on the road to healing...? He showed me some ways to sleep with pillows, sleep has gotten terrible the last few nights--I instinctively roll at some point from my side and in starts burning all over and wakes me.
Thanks for all the help,
khaki

Sounds like a pretty good PT person so far..

Checking and mobilizing the first rib, is what it sounds like to me.
My chiro, the adv PT guy & the PT teacher all did it a few different ways for me, but the idea is the same.

I hope he does check around for Trigger point also.

It was a multi pronged approach that worked for me.

reduce the spasms
resolve as many trigger points as possible
drop the top rib/s back into place


I did most of the posture work at home
but chiro adjustments really helped with the forward head/shoulders & the hump at the back of the neck area..

Thanks Jo*mar--I was hoping you'd reply-I feel WAY better hearing you say that. He did also try some trigger points and talked about doing more with that next time, and bringing in one of the other P/T to talk with me more on posture--thanks, I feel relieved that maybe I'm on the right track :)

The pain and PT you describe sounds like par for the course with TOS. The fact that you also have carpal tunnel is a complicating factor.

You must get the sleeping under control. I was once caught in the vicious cycle in which sleeping was making me worse each day. I started seeing a neurologist who's specialties include pain management and sleep disorders (I don't have sleep disorder...just pain). I suggest seeing a pain management doc and finding the right drug regimen. With this bad pain, it must be managed or else it just multiplies.

Now I start my mornings out feeling pretty good (especially after a long hot shower). Things still go downhill as the day progresses. But, it is hell when you wake up with excruciating pain and know it is only going to get worse. You must avoid this place.

In the past many with severe pain ( and post op) would end up sleeping in a good recliner or using many many pillows to prop & position the body.

After my first surgery, I found it necessary to sleep almost sitting up for the first few weeks. I stacked a bunch of pillows below me and put a rolled up blanket on either side of me, so that it would be much harder to roll over in my sleep. I am a "side sleeper", so it definitely was not comfortable, but certainly better than dealing with lots of pain the next morning.

Take care. :)

Pillows?
 

What is the best type of pillow to use? I love my down pillows I can make them pretty flat,but I've been waking up at night with bad pain in my trapezius muscles and heavy arm and hand. I usually end up using no pillow by the am.

Has anyone tried using a neck pillow? I tried one but I think it was too big.

We have a mix of pillows and when I was in pain I used all sorts of configurations, whatever worked best..
I have 2 sizes of the contour memory foam type now, small and medium, and I try the larger size and the smaller size curve/bump to see what fits best for me.

Some liked the long body pillows for propping/positioning the body.

I'm a light sleeper so none of the noisy pillows worked for me -
like the Styrofoam beads and the husk? or hull pillows. (buckwheat hull)

is worse after p/t norm?
 

one more question--first p/t was yesterday--today I feel worse, severe burning in chest (right side mostly) and behind rt shoulder blade--burning behind both arms.
i don't go again until next wed.

My PT sessions were always 2x a week for about 2 weeks then spaced out more as the symptoms resolved...:confused:
I think the first set might have even been 3 x a week.

And later when I started with chiropractor and was in severe spasms he had me come 3x a week till we got the spasms resolved.


*My first sets of PT were only focused on the hand, wrist, elbow, arm pain as it was a w comp claim and nothing beyond that was addressed.

Finally got sessions for chronic shoulder/neck strain later on and more of the rsi pain/sx resolved with PT on the neck & shoulders....
Soon after that was when I started to find info about TOS.


*** did PT say to be sure to drink lots of fluids, tx can cause toxins and crud to flush out of the clogged up system, and water helps to flush it out.
Also could be delayed pain due to the pT session and the movements. If it get really bad call the PT place and let them know you are in quite a bit of discomfort.
They may say to come in for some gentle modalities.
Did they do any heat, ultrasound or massage, or e stim before or after the rib mob work?

My PT session /and chiro all used heat, massage, e stim BEFORE doing any other therapy.
It softens & loosens the tissues so they release more easily. That is what they all told me and it made sense to me.
Often I would go home and use ice after the RSI ( hand/arms) PT sessions, but ice/cold didn't feel good at all for my neck/shoulder stuff.