Hands and wrists weak and wasting, Bilateral TOS?
 

Hi,

I'm a 43 yr old male and for the last 10 years, i've had gradually weakening wrists and grip, and in the last year, i've noticed muscle wasting of my hands and forearms. The wasting is uniform across all fingers and back and front of hands, really weak grip, struggle to wash up, handwriting is suffering and I dread handshakes as my hand just crumples and is painful.

I wake most nights with numb hands or fingers and my hands are sensitive to cold, i've had to give up outdoor swimming as they just go numb now.

I'm otherwise very healthy, regularly train and compete in triathlon, am still competitive in my age group locally.

I was born with congenital hypotonia, sat up and walked much later than most babies, but made up for it and became quite athletic and sporty all my life.

I was x-rayed after a car accident 20 years ago, remember I was told I have an extra vertebrae in my neck (no mention of extra ribs), it was just a passing comment by the radiographer.

10 yrs ago I started to notice hand weakness, so I went to GP who sent me for tests suspecting MND, EMGs etc all came back normal so I carried on.

Saw a neurosurgeon last year who agreed my hands were weak but said it is gradual and not much can be done, put it down to my birth hypotonia.

Its getting more painful to use hands now, lifting pans, gardening etc are really tough, but rest of me is fine, even broke a few personal bests running and cycling this year, but swimming is suffering.

After reading about TOS on here and British Medical Journal entries, Im going back to GP to discuss where to go next, I'm scared i'll have really useless hands in a year or two if nothing is done.

I've started some TOS exercises from a study where 88% of participants showed improvement, but as my symptoms are so gradual, I'm not sure any improvement will be noticeable.

Any help or advice is much appreciated, thank you for reading this...

Matt

I'd request more x rays and /or MRI of neck and get that extra vertebra or rib clarified...
Might be wise to look for a TOS experienced surgeon first..or afterwards if extra ribs do show up..

The car accident could have made for some internal scar tissue , also a prior whiplash can be a factor with TOS and ageing..

Explore all of our sticky threads , so much saved info , knowledge will helps you know if a DR or therapists is helping/helpful or not..
Bad PT / treatments can make it worse...

Any symptoms with your neck?
tight painful, any general soreness or limitations in range of motion?
trigger points, muscle spasms?
Sometimes you don't notice those until you get a massage, PT or DC and then you might notice how much looser the neck & upper back can feel..

But if something is compromised and pressing on the nerves for the arms then you may not have the neck & upper back issues as much..

Did you find the blood flow test to check if blood flow is cut off when arms area raised (turns hands/arms white) then blood rushes back when hand are lowered turning then reddish/pink.. small % of normal population has this without issues..
It would indicate some blood flow issues also if your hands turn white..
If not then possible nerve or NTOS.
VTOS is Vascular issues..
one from the sticky - Nismat / Patients / Injury Evaluation & Treatment / Head Neck & Back / Thoracic Outlet Syndrome: More than just a pain in the neck