[firemedic2524p]

Hello all. I ma a 29 y/o Paramedic from IN. I was dx with TOS after my neuro surgeon found that I had a cervical rib in 2003. I began having severe atrophy of my right hand and muscle fasciculations. My doc went in anteriorly and "snip the cartilage bands" around my rib that were compressing my brachial plexus. Well the atrophy didn't get worse, but it hasn't gotten better. Now I am having severe neck pain and my left arm is starting with the numbness. I had an MRI scan today and they want me to see a pain mgmnt doc on Monday. He wants to do either a block or steroid injections. I am off work right now due to the pain and inability to take pain meds and work. I am very frustrated and would appreciate any insight into this new condition.

Mike

[Jomar]

Hello & welcome,
Sorry to hear you are having more problems.

Have you have any sessions of PT?
I'm talking about expert/advanced /knowledgeable PTs not rookies or avg run of the mill PTs.

Did you find our sticky threads up above?
http://neurotalk.psychcentral.com/thread84.html
http://neurotalk.psychcentral.com/thread135.html

[firemedic2524p]

I had not... I'm new to the site and still learning my way around. Thanks for the info...

[TraceyW]

Hi Mike,

This site is very, very useful - i dont have any extra ribs and believe my TOS was caused by a fall down some stairs and overuse/bad posture on a computer for 5 yrs!. Im 27, so a little younger than you....its a fairly scary situation to feel so weak and in pain when you should feel on top of the world! (of course that goes for any age tho!). The forum has been a little quiet this last week or 2 so i think many members are on holidays etc - im sure they'll be back soon so offer some words of advice!. they are very, very knowledgeable and supportive!

Take care

[tshadow]

I have seen two men get the TOS surgery and do very well and return to work. I would suggest that you go to Denver (which many of us have done, it's just a plane flight) and see the three top docs there. Or see the list of docs we've posted and see if you have a good surgeon nearer to you. With an extra rib, I'd really seek out removing it and having a brachial plexus release surgery. At least you have something wrong that can be seen - many of us have neuro TOS which has no obvious abnormality, which makes surgery a real shot in the dark.

Good luck.

[gibbrn]

Welcome,
sorry to see you here but you are in the right place that is for sure!!!!

I am a nurse and also have cervical ribs. I was working out pretty hard when I had a little numbness and tingling in my arms and hands and was told it was menstral and I was just carrying extra water....YEAH right.....anyhow.....no more issues until I lifted a 180lb dying cancer patient up from a toilet and WRECKED my neck back and shoulder since dx as Tos on my right side. I had my arm under the patients arm to lift a pretty much dead weight and I was about 135 solid muscle size 2. small but mighty I may add! there was someone helping not silly enough to do on my own but sink in her way so I got all the weight.

I would imagine by your name that you are a firefigher and medic???? heavy lifting and likely you work out like hell! So if you do overhead military style press or anything overhead to build up your shoulders and neck it will decrese the space in the brachial plexus area for your muscles and your nerves. The docs may have removed the bands or cartlidge but it may not be enough space if you are in great shape. I had my first rib removed and a scalene muscle taken out. It was amazing and was off all my meds and feeling like my old self until physio had me do stupid things that brought my tos back with a vengence. I was lifting weights and exercising my neck too much...etc etc....bad situation all around.

You likely need the rib out for space for your normal anatomy. They don't take our wonderful extra c7 process ribs out they take the first one out! Hurt like I was run over by a car but well worth the pain for 6mths pain free!!!!!

Likely Denver is the place to be. You probably need the usual TOS work up ???? in the sticky area with all our info Not sure on that but I would assume it is.....so MRI, Veinogram, or MRA in provacative positions....ie superman fly position or overhead arms, EMG, testing on both sides to see if it is bilateral or unilateral. Lots more info to be had and it is all on the site in the sticky notes.

Pain management is fine so long as you have a long term plan. You will need to stop the muscle wasting and keep what you have so that will need to be addressed asap. You need to get meds to cope with the pain for sure as it is hell and DO NOT be afraid to take them or don't let them brush you under the rug if you are a medic you know your stuff. so pain management is a place to begin.......you need a full work up by a vascular surgeon as well as a neurologist to see what the full scope of your TOS is.

Hope some of this helps!!!
take care,
Victoria RN