Scalenectomy - I have questions
 

So first off I have TOS from repetitive strain caused by computer work - > now I have injured scalene muscles. thought about posting on the sub-forum but it was inactive.

I will get to the point. a scalene muscle is being cut off - > does it regrow? if so, how? does it grow injured, does it grow healthy? does it even grow back at all? I have hard time to imagine my life will be so great without major muscles supporting my neck. I want healthy muscles - is this the correct option? (I already tried PT)

I would not do surgery unless there was clear proof that it is the only option..
Use our search tool- for scalene , surgery and more-
https://www.neurotalk.org/search.php

And our sticky threads are full of info..
https://www.neurotalk.org/thoracic-o...les-polls.html
https://www.neurotalk.org/thoracic-o...rps-short.html
https://www.neurotalk.org/thoracic-o...o-threads.html

Thank you for the list of surgeons, has anyone heard of surgeon povilas pauliukas?
and I am still interested about the scalene regrowth thing.
cant find info on your search.

Scalene may reattach to other things in the area.. but not always.

How long did you try PT for? A lot of people go for a month, 8 weeks, don't see changes and quit.. believe it or not, it took a long time to get to where you are and it takes a long time, a lot of pain, and a lot of work to get better. Still, it may not work for everyone but I'd exhaust all possibilities before I had someone remove anything.

It took multiple sessions of PT & also expert chiro, plus a focus on doing home care follow up and not working for me to recover from chronic & acute RSI/TOS.

4 months.

2 months of this:
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then this for 2 months:
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and something like this:
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&&more exercises.

results: much better than it was, but:
anterior scalene still tight(the main cause)
CT angio still shows artery compression
still hand pain - brachial plexus compression
still cold hands,
still head problems.

Sure I can keep on trying - but at this point it will just be a miracle to solve it by my own. So yeah, looking for the best surgeon out there. removing this little muscle and then rebuilding it from scratch - is it such a bad idea? why?

Think more in years than months , even longer if you are still working or doing same activities that caused the problem..

Surgery- [ is it such a bad idea? why? ]
these issues have happened to past members..
A possibility of some internal scar tissue that can cause problems after the surgery.
Sometimes a reattachment happens ( in the wrong place) if scalene is only cut , or if only a small section is cut out..

May not solve the main problem..

I know there is a lot of info in the stickies, but they are very informative.. Don't try to absorb it all in a few readings..

**note in edit line**

Second, good point you raised there -
but what makes you think that by doing exercises, my injured scalene tissue that is compressing my veins, arteries & nerves is going to simply heal itself perfectly? that doesn't make a lot of sense aswell since it's physical
structure has been deformed. my idea is this: finding a genius surgeon that will make sure there is no compression, then slowly rebuild the muscle's strength.

I tend to agree with Jo*Mar. Of course we don't know how much pain you are in etc. Each case is different. I probably wouldn't be letting someone go at me with a knife unless I had already had a clot or was at serious risk for one. Since I am not in this category as of now, I won't consider it.

I've also researched on these forums quite a bit and surgery can be very hit or miss even with the very best surgeon. The truth about TOS is there can be many points of compression, although you might feel pain in your scalenes or neck region, it doesn't mean cutting that out will entirely remove the problem. Doctors also can't just rebuild the scalene muscle. Once it's gone other muscles will certainly compensate and that could lead to other issues, or issues on the other side.

Many folks have had issues with the scar tissue after surgery as well.

I would look up TOStinman on YouTube. He's a member here but he is more active on YouTube. He had the scalenectomy done and his symptoms didn't really improve. Of course it could get better.. but in my research it seems like a coin flip.

Either way best of luck. I check up here time to time even though the forum is mostly dead it seems. I don't do Facebook so I don't really want to go on there for groups..

knowing that your subclavian veins and arteries are compressed(CT ANGIO) - wouldn't you go through surgery in order to release these vessels? I mean, it exteremly hard to release it otherwise.

Also - I have a question; I have TOS on my left side, which is my severe side, but on the other side I have scalene tightness too, but only sympthoms seem to be right-ear problems(ear poping, tinnitus, can hear blood pumping sometimes). Does anyone have any info about that? is that even related? it bothers me a lot too.

thanks!

It's pretty common to have ear symptoms with TOS. You can search the forum to get info on that and others experiences. I get the popping and wooshing sensation from time to time. It could be from scalenes or it could also be from the SCM.

As far as surgery, if the doctors said you have compression I would listen to their recommendation. If they are saying surgery it might be your best option. With that being said it depends on how severe the compression is. When I first started I had cold hands a lot and felt like my circulation was very poor. Over time I find that I have less circulation issues. Now most of my issues are pain and tightness of scalenes, SCM, pec minor and scapula muscles.

Thinks to work on - stabilizing scapula if you have that issue.
Breathe with diaphragm, try to consciously do this throughout the day..(this is probably the hardest for me)
Work on posture and back strengthening exercises.
Rest your NECK, every moment of the day we use our neck, take time to lay down, hang your head off a bed, let the neck muscles lengthen and relax.
Self myofascial release with a foam roller helps a lot, I find the lacrosse ball to be helpful as well.
Warm heating pad on your neck can be amazing.

Good luck.

Again - thanks for the info.
I already worked on strength & posture. the improvement is temporary only. I still get every TOS symptom possible. I am looking for a real fix, as you can see problem still exists:
Regarding my ears: my ear problems are very different. I wake up with right-sided tight scalene + clogged ears and tinnitus. it calms down when I let my neck rest. left side causes so much issues my life is really bad... take a look(still waiting for a formal answer on this btw by my doctors):

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Why didn't you consider surgery? perhaps your situation is not as bad as mine?

Yes, I get the full ear feeling regularly too, like I need to blow my nose to depressurize the ear. It comes and goes.

You ask why I haven't considered surgery? I have a lot of reasons.

1. It's a serious surgery, and I'm just scared by simple "routine" surgeries/surgical procedures.

2. Alternatives to thoracic outlet syndrome surgery? How you can take control! - YouTube

3. I think it can be corrected, I just haven't figured it out yet.

I am in pain almost all the time, weird symptoms in my arm. I don't get numbness or tingling in my arm so much honestly. It's mostly pain anywhere from the base of my neck on right side down to my little finger. My pc doc really doesn't think I have TOS. She just cites how rare it is and sent me to a shoulder guy. They did MRI and had a nerve conduction study on me. Both turned up negative except for some tendonitis in the supraspinatus. They gave me some meloxicam and said c ya in 6 weeks. I didn't take it cause I've already been prescribed that same medicine in the past and it did nothing. My PT is pretty aware that I have TOS. She said im getting good circulation most of the time but I have a very weak unstable shoulder.

I encourage people to read a few studies I've found to maybe see the light.

At least in my case, I feel my TOS came from a big underuse of my arm for a long period of time, with an immediate over use very quickly. I tortured my shoulder and it eventually gave out giving me TOS symptoms. Instead of my top rib coming up, which is what most people will tell you happens..my shoulder being lower and dropping down on the right side is causing it to sit on top of the nerve and vessels a bit. I'm training my body to be able to support my shoulders again, and hopefully lift my shoulder off of my veins.

Another condition known as "dropped shoulder syndrome" Is very similar to folks with TOS if you read about it in the article. A LOT of people with TOS describe these types of symptoms, weak shoulder, winged scapula etc. A large portion of these people recovered with a rigorous exercise routine done daily for 14 weeks.
Dropped shoulder syndrome: a cause of lower cervical radiculopathy. - PubMed - NCBI

The idea that most "overuse" or RSI injuries come from UNDERuse - “Underuse” as a cause for musculoskeletal injuries: is it time that we started reframing our message?