is this elbow pain TOS? who can diagnose?
 

I haven't been around for a few months as I've been off having another surgery which I am recovering from. I hope everyone is doing as well as can be.

I'm still trying to figure out who to see to test for ulnar nerve compression...or whatever these pains are that travel along the nerves above and below the elbow. The local Thoracic surgeon told me that some of my complaints are not TOS so I would like to get as good of a diagnosis as possible. The reason being is that my L side tests much worse with TOS but I am aching to use my R arm and if I were to do the TOS surgery it will be at least another year before I would get to doing the R side. If I do have something simpler on the R I would like to address that now.

Any suggestions of kind of doctor? Neurologists are no longer an option for me as I've been through them all locally. I still want someone to diagnose any problems in addition to the TOS. The Denver doctor was fine for prooving TOS. Is ulnar nerve compression the same as tennis elbow? I had a recent EMG that didn't show much but have never had a SSEP test. I doubt that the EMG was done well; the tech used a book to look up what the denver doctor was asking for as she had never heard of it.

I also have pain that I wonder if is TOS related. It doesn't travel in the same way as the nerves above and below the elbow pains do. This pain is on the inside of the elbow. When I put my arm out palm up, it's on the pinky side just above the elbow. It hurts a lot if I try to hold something. And I often wake up with one or both arms hurting there. It's also a very tender area when I poke around there and the tissues feel very bumpy inside.

Thanks much for any insight! and I am Hypermobile if that info is useful

Hi fern,
For myself, I was amazed at how many of my symptoms were caused by misalignments, trigger points & sticky fascia. Hypermobile too:eek:

Once the chiro got me into a better alignment and reduced the pain/spasms with US, LLLT, IF stim & some Nimmo{a TrP/massage mix} I rarely have any elbow/arm/hand pain anymore.
Unless I really do heavy or intense projects, my main thing now is the aches in the neck and upper back and some times tightness if I don't do the self care stuff.

Last winter my wrist acted up after stacking a lot of firewood. A few days later was my chiro appt, he worked my wrist joint around, mobilizing it, and then did some quick massage on my arms, checked my elbow, and then had me brace against the wall while he did a traction/ pulling / and then some slow motion yanks on my whole arm- amazingly it worked. I suppose it was some sort of aggressive modified nerve stretch.

have you seen this pressure pointer chart before - with the clickable links?
http://www.pressurepointer.com/pain_reference_chart.htm

it shows where TrPs can refer pain to.

Fern,

I would recommend trying to find a doctor who is very knowledgeable both about TOS and all other arm problems, both nerve and ligament/joint related (I think tennis elbow is more of a ligament type injury than a nerve injury).

If you're within traveling distance of southeastern PA, I'd highly recommend Dr. Scott Fried (610-277-1990) , who is an orthopedic hand surgeon who has additional training in surgery and treatment of TOS. He believes in looking at the patient as a whole, diagnosing and treating all problems in the entire upper extremity (neck through fingertips) using both traditional and alternative treatments, with surgery as a last resort.

Dr. Fried's online résumé:

nervepain.com/drFriedDetailed.html

Many of his patients have more than one type of injury.

Also, the EMGs done at Dr. Fried's office are done by experts in performing EMGs to check for TOS and other upper body nerve problems. Mine have been done by Rick Reed, who DiMarie has mentioned in past threads like this one:

neurotalk.psychcentral.com/showthread.php?t=14165&highlight=Rick+Reed


If not, you could check to see if other TOSers in your area have had any good experience with orthopedic, sports medicine, or physiatrist type doctors who also have enough knowledge of TOS to sort out and treat the cause or causes of your elbow pain.

Regards,

ThreeForOne

Fern,
I also have that exact same type pain around my elbow area. I cannot pick up anything that requires a fist type movement of either hand. I have to be very careful about grasping anything.
I have several tests, EMG etc. and my thoracic surgeon has confirmed that this is part of the double crush injury that is part of my TOS. There was some suggestion that a ulnar nerve transposition might help, but I am uncertain that that is the answer for me right now.
I am still trying to find a way to deal with the pain that it causes, but hopefully I will find something soon.

tendonosis and TOS
 

Thanks all. I've been reading about tendonosis at http://tendinosis.org/ which I saw at sorehand. I think that I probably have tendonosis in many body sites (not all upper body) as well as the dx bilateral TOS and previous dx of various tendonitus sites which either didn't heal or returned. So I've been thinking that it would be good to get that evaluated. What do you think the relationship is between tendonitus/tendonosis and TOS? I can see that hypermobility could be related to tendonosis and bodywide RSIs but I haven't ever understood if tendon injuries are precursors to TOS.

"Therefore, tendinosis is a slow accumulation of little injuries that are not repaired properly and leave the tendon vulnerable to yet more injury. This failed healing process is the reason many people with tendinosis don't completely heal from it and can't go back to their previous level of activity. Once the tendinosis cycle starts, the tendon rarely heals back to its pre-injury state."

I second Dr. Fried. He spends time with every patient and will fight for you. Cares about your future. Also teaches wonderful self-hypnosis classes.

The first symptoms I had of TOS worsening was severe elbow pain when grasping. Now its occuring in other arm(elbow pain) shows its worsening there.

Hi All,

I have noticed in the past few months that my right elbow is also sore. It seems to flare up when i do some lifting of groceries etc. The flare lasts a few days then seems to go away appearing again when arm is used for lifting etc. I just thought it may be overuse??? I have TOS more promient in left hand side, so I just presumed this was from overuse of my right arm. My dr tends to agree and thinks its inflammation from overuse.

Ozzy

Hi Fern! Glad to see you around again. I have tenderness or soreness on that exact same part of my elbow - kind of weird, since I have vascular TOS. Is your circulation in your arm okay?