Thoracic Outlet Syndrome
 

Has anyone ever seen Dr Stoxen, DC for Thoracic Outlet Syndrome. He is in Chicago and he doesn't believe in surgery for TOS. He only sees one patient at a time and works on them for up to 16 hours a day. For out of town patients he works on you until you have no pain.

Sounds expensive. Link?

Dr Stoxen
 

I believe I found his name on this website. I had surgery that fixed part of my TOS. I have been told takes long time to recover. I would pay the 2,500 day if it cured my other TOS issues. Just wondering if it really works. I am only 45 with a 5 year old and I want my life back. I spent the last two days in bed due to the burning pain in my left arm and headaches. I want to live again.

I would be suspicious of anyone who says he works on you until you have no pain. TOS doesn't work like that. No one can guarantee no pain. Even for those with good surgical outcomes, I've heard very few claim they had no pain whatsoever.

I am trying to figure out if he is what he claims to be.
*edit*

I posted the link in another thread. Search Teamdoctors.com. sounds intriguing.

What do you think of this doctor and his theory on treating TOS?
I did talk to him. It was kinda one sided. I want to believe to get better but I am just not sure. I guess I will find out. I am going to speak to him again after he reviews some of my records. Thanks for posting the link again. Any thoughts would be appreciated.

This sounds really fishy to me. If you go the non-surgical route, you're looking at months upon months (or even years upon years) to get anywhere close to "pain free." As I understand. "pain-free" just doesn't happen. No doctor is going to work with you and only you for that amount of time.

Any doctor that 100% rules out surgery for TOS has his own interests in mind. He's trying to sell hope to people with TOS that don't want the grizzly surgery that comes along with it if they have a vascular form of TOS or neurogenic TOS that isn't responding to PT or other treatments. That's ridiculous. Not surgically treating vascular forms of TOS is a dangerous thing.

I'd run from this doctor and find one that has more moderate views on the matter. Any doctor that rules out a treatment entirely under all circumstances is a crock.

Well, he's not a medical doctor.

Surgery doesn't usually resolve all related factor for TOS pain & symptoms.

Myofascial pain, trigger points, other c spine issues, or spinal misalignment's, poor posture that contributes to a circle of pain.

If you can seek out a highly skilled and knowledgeable PT, or chiro, or body worker in your area, I think you will be better off with someone nearby.
The chiro I went to used a variety of modalities & manual therapies as well as adjustments to help me.
The other clients I talked to while in the waiting area all said they felt he had special skills.

It takes a lot of time to repair/resolve the damages from TOS , and a quicky round of treatment isn't going to last. IMO.

I agree with jomar

Just find a really really good fascia/pt chiro for tos area (for NTOS, vascular i don't know about)

But if you have myofascial pain syndrome all over that means your metabolism is busted imho

Stoxen claims to have seen 30,000 TOS patients and not one had surgery.

I watched his lecture, he definitely has extensive knowledge of TOS but I have a very hard time believing his assertion.

https://vimeo.com/22362794

Interesting video. I watched the whole thing. TOS is more complex than most people realize.

30,000 patients is a lot
 

30,000 patients is a lot. It seems funny to me that no one here seems to know much about him. It seems like people would be singing his praises.

i havent seen the whole video but his point about not stretching your neck bc it pulls up the rib is good


i dont agree with the shoulder stuff

he thinks tos is way under dx'd so that's probably how he's seen so many tos patients.

I watched the whole video and agree with much of it, including the shoulder stuff (TOS presents differently in all of us). I believe conservative management should be attempted before surgery and the therapist needs to be trained properly in rib mobilization. I wouldn't travel to see this guy expecting a miracle however.

http://teamdoctorsblog.com/2012/08/0...-dc-chapter-1/

[Since 1986 we have had over 30,000 new patients]
[we have numerous cases of thoracic outlet syndrome]

[I thought the 30,000 was very high number if only TOS patients - but that # is for all their patients/clients.


I think they do have some very good info mentioned, but I wonder about the limited number of sessions /time frame of treatment equaling lasting results.
Especially for anyone that would be traveling a long distance.

Let me express the problems I had in watching the video.

He makes it seem like medical doctors do not have a patient's interests in mind and implies chiros are somehow more altruistic.

He does not talk about the serious vascular risks when some vascular cases need prompt/immediate surgical intervention.

He spends only 15 secs at the end of the video stating that patients failing conservative treatment (12 weeks without improvement) require surgery. Yet he says he's never had a patient have surgery. My only guess is he never hears from them again once they start down the surgical path.

I don't like chiros that perpetrate as medical doctors and this guy strikes me as such. I do see a chiro who I like.

Dr Stoxen
 

Thank you for your perception. I have been seeing neurological chiropractor and massage therapist. My shoulder doesn't move properly now. I think my problem is now muscle from no being able to use them for so long and all the Botox they tried.

There is a member named "drewanderson" who stated in another thread that they flew from Florida to Chicago to see this chiropractor and said that they really helped with the TOS. Unfortunately, the info provided was not very specific or detailed so we are left wondering exactly how it helped or what treatment was provided.

Id love to get my fascia released by him (jokes). He does seem very knowledgable about that

But strengthenng stuff is wrong

Strengthening your levator scapula is a terrible idea
And I bet most people do not have week latissimus dorsi muscles if anything theyre hypertrophied

He didn't talk about pec minor enough but the scalene information was great

In the article at http://teamdoctorsblog.com/2012/08/0...-dc-chapter-1/ he says he doesn't strengthen until after muscle spasms are cleared and the first rib is adjusted. That doesn't sound unreasonable to me.

And when he mentioned strengthening the levator and the upper trap, it was the for the purpose of elevating the shoulder girdle. For people who get relief from the cyriax release position (as I do), this would seem to make sense.

While he didn't go on and on about the pec minor, he does mention it as a factor in his first two treatment cases.

I'm more positive on his presentation than you guys are. I see at least the following differences in his treatment approach vs. the PTs and chiros I have seen to date:

-- more numerous hours on deep tissue work to clear out spasms

-- emphasis on methodically going through all related muscles. I feel like my current chiro cherry picks a couple obvious ones (pec minor & medial scalene) because there is < 30 min in the appt anyway. No time to go through everything even in a 45 - 60 min PT session.

-- special attention paid to scalenes. I don't think anyone that I've seen has directly worked on my ASMs and they most certainly need it.

-- a clear progression: spasms THEN adjustments THEN strengthening

-- special attention paid to daily postural habits. I don't recall Joyce Wilkinson or Art Ando instructing me on avoiding positions that would stress the scalenes even though they knew I had TOS

So I'm thinking about going out there (Chicago/Stoxen) as I have plateaued with my current chiro just like I plateaued with all the other PTs and chiros. I wouldn't mind hearing more from @drewanderson on his experience as it unfolds.

Upper trap yes if your shoulder is truly winged (like my right side) but NEVER levator scapula!!!! The real problem is the serratus anterior. Its not simply shoulders being elevated or depressed...its their rotation

Why would he mention lats and levator but not lower traps and s.a?

there's research on this all over the net, just off the top of my head:

http://osteobcn.files.wordpress.com/...ome-part-2.pdf


Ive stretched my brachial plexus to death (aka cyriax test) what most people have here is downward rotation syndrome. The levators and lats and pec minor turn on bc theyre doing work that the lower trap and serratus anterior should be doing. Theres real winging and pseudo winging. I wish i was a pseudo winger

Dr evan osar has tons of information about this and hes spot on.

I agree tho you cant do any strengthening if your fascia and rib are jammed in the wrong position
(Or something systemic like my mg deficiency)

I agree - this approach does seem reasonable. Questions is, if you have to travel, how do you achieve the desired benefit if you aren't able to go on a regular basis? I worry that one visit would not provide optimal results.

Right, he states 12 sessions before declaring conservative treatment successful or failed.

Exactly! Unless you can afford to stay for a month - how would you get in the desired 12 sessions. I wish people who comment on treatments, surgeries, exercise, PT, would come back and elaborate in more detail. Some just post something we all find interesting or helpful, then they disappear!

I wish they would too, but i normally just assume that whatever the last treatment they did either cured them or killed them!

Ha, ha, maybe so. It's frustrating when ppl say something helped them - but then offer no details or helpful info. I often wonder if they are legit!

I have family and friends in Chicago so I will check him out when I go visit-maybe in September. I think you need at least 2-3 weeks of treatment with one person to see if it helps. I have been seeing Art Ando for 9 months and I am 50-60% better-but have plateued and looking for some other options. I think time and rest from repeitive work has been the best thing for me.

once my pt got my fascia to loosen up i could adjust my first rib myself but i dont have the same scalene problems that most of you have

12 sessions is nothing, you have to wait years to figure this stuff out

Thanks for sharing; looks interesting. But note that the paper above is from 2009 and his presentation is from 2004 so he couldn't have been aware of at least that paper. :)

Also, with nine years having passed, we don't know what tweaks and adjustments Stoxen may have made to his protocol.

I don't think you have said why the levator shouldn't be strengthened other than implying that its because its better to strengthen other muscles. The "NEVER" is pretty strong though.

In the article, he states:
Again, that sounds reasonable.

Re: out of town travel, IIRC you do multiple days in a row and multiple hours per day. I don't know if one trip lasting a week or two (plus ongoing self care) would be enough, or you would have to go back. And it could (will?) vary by case.

And don't forget that Neurotalk often collects the worst cases. People here are taking Stoxen's comments about the treatment course and applying them to this group--the TOS Misfits. (Although his Sonny Burke case sounded pretty severe like us.)

The best TOS case I've heard of was an acute one. A guy fell off his motorbike and his first rib got jammed up producing all the usual TOS symptoms. Treatment was one chiro session and it fully resolved the problem. But he didn't have "long term" TOS or any confounding factors like RSI, TMJD, EDS, etc.

Now I'm just rambling...

Hopefully we will hear back from the person who posted that they were treated by Dr. Stoxen or someone who posts regularly will go and report back.

AND Trigger Pt injections monthly. The other say I had TRP injections just in my teres muscles which is usually one of the bad places and it helped right away-we'll see how long it lasts.

Why would you strengthen a muscle that isn't weak and refers pain into the neck?

We were discussing treatment duration earlier in this thread. In a comment on the Stoxen post from 10 days ago, Stoxen wrote:

"Many patients who read the article have called from around the world flew into Chicago to visit me at Team Doctors and had their TOS resolved in a matter of days with our 8-12 hour/day round the clock treatments."

He say "days". I'm guessing that means 3 - 5, maybe 3 - 10.

But as mentioned before, each TOS case can be different.

I do wonder if getting 8 hours of treatment in a day would be overbearing. :eek:

Thats a good point

I know i couldnt handle 8 hrs. Nervous system is too sensitive

8 to 10 hours - wow! That seems unrealistic. I would need to hear testimony from actual patients who have been thru this treatment. I could understand going to 10 or 12 separate apts but this seems like TOS overkill!

Dr Stoxen
 

I talked to him and out of town patients stay foe 4 or 5 days. He treats you for about 16 hours a day. He says you are done when you are pain free. I sent him all my MRIs and reports. I am waiting to hear back from him. I have plateaued in my recovery process. I see a Chrio and MT. My Chrio said it does work because they can spend so much time on you.

And what if you don't become pain free? Then you don't have to pay?