Unable to get diagnosis, assuming TOS?
 

Apologize for the long post, but needed a place to lay this all out after a year and lots of $$$ spent to no avail. Quick background: I've been an avid weightlifter and runner for 10 years, while also participating in sports from a young age. 30s now. Have spent all of my career at desk/computer. I'm assuming at this point I have nTOS and/or some other compression in the shoulder area. Below is the progression of my symptoms.

Jan 2015 - deep, non specific shoulder ache in brachial / trap / rotator cuff / collarbone area. Progressively worse over next month. Stopped lifting overhead, did rotator cuff rehab per ortho.

MRI shoulder results negative, slight ac joint atrophy. X-rays negative. Diagnosed with shoulder bursitis.

Next 6 months - Pain lifting arm up/overhead in brachial area. Deltoid/triceps twitching. Neck pain. Deep shoulder blade pain. Light pinky numbness.


Sep 16, very painful and numb pinky, partial ring. Burning palm, hand. Hard to type or sit. Intermittent cold hand. Deep shoulder blade, brachial, and collar bone pain. Heavy/weak arm feeling. Quit working out, stopped running. Wrapped elbow in towel at night. No leaning on elbow. Saw GP, ordered cervical MRI which came back negative. Referred to neurologist who ordered EMG.

EMG showed no ulnar sensory response at wrist, might(?) be elbow. Everything else normal.

Now: slight pinky numbness, deep shoulder ache after sitting at computer, collar bone/brachial area tightness and pain. Light throbbing arm pain. Stinger/bruiser feeling when reaching out. Heavy/weak arm feeling. Hand tingling when pinching shoulder blades together/down. PT for 1 month but not much improvement.

Neuro has now ordered an elbow MRI with contrast, and if negative, a plexus MRI. Would it be worth it at this point to see a vascular surgeon for a second opinion on TOS? The physios thought it was, but the neurologist mentioned that was "reaching". Thoughts, help??

I'm just a random dude on the internet but you have the same symptoms as I do exactly. I had the same normal neck MRI and ulnar loss, and I was diagnosed with nTOS based on that by a neurologist. If I were you I would look forward to the plexus MRI, I can't see the elbow one showing much, but I could be wrong too!

Let me know how the journey goes, I love hearing about the trials and tribulations folks have with TOS, especially when their situation is so similar to mine, as I feel like I can relate.

So elbow came back showing 'mild' flattening of ulnar nerve near triceps longed, by cubital tunnel. I've had NO subluxation however.

Met with another ortho surgeon who has me all set up for ulnar transposition (subcutaneous). My biggest concern is that my symptoms up near my shoulder/brachial are strongly related to my numbness - he assures me they are separate issues.

I can re-create the 'deep ache' and arm pain when messing with a certain spot in my scalenes, and PT has helped that portion of it (not the numbness however).

Hopefully this surgery isn't unnecessary and truly addresses the root cause of this. If not, oh well.

Keep seeking better physical therapists and maybe even chiropractic care , expert & skilled, knowledgeable of soft tissue. etc.. perhaps uses many modalities .. IF stim, trigger point, LLLT, posture work...

our sticky threads are full of tips & information - to help you get the best results & care..
https://www.neurotalk.org/thoracic-o...rps-short.html

https://www.neurotalk.org/thoracic-o...les-polls.html

https://www.neurotalk.org/thoracic-o...o-threads.html