[sphdallas]

I have been diagnosed with right side TOS. Atrophy of right arm and hand took me on a search to find out what was wrong. I had carpel tunnel and ulnar nerve surgery 7/2008 which didn't help. Actually things got worse. On to more doctors...my internist, a neurologist, 2 orthopedic doctors and a nerve specialist. Finally the nerve doctor said highly probable TOS. Treatment: 1. Surgery or 2. Physical Therapy. Of course I chose the later. I began PT in April this year. Things are somewhat better...better posture and not as much winging but I am having difficulty with using right hand. It bothers me greatly. Any ideas or suggestions? I feel lost and really get upset with the lack of strength in my right arm and hand.

Thanks!!

[Jomar]

Hello & welcome,
What kind of therapies are they using/doing for you at PT ?
And what are they having you do for home therapy?
How is your pain level on average?
What are you most bothersome symptoms?


My PTs told me that when the worst of the pain & symptoms are resolved , then the strength will come back in time. I think I read that somewhere too. Seemed to work out that way for me, especially once I got the really good PTs & my chiro.
It did take over 2.5 yrs to get it mostly resolved- part of the problem was the wc system ... denials, change of drs & PT places..

[boytos]

Originally Posted by Jo*mar

Hello & welcome,
What kind of therapies are they using/doing for you at PT ?
And what are they having you do for home therapy?
How is your pain level on average?
What are you most bothersome symptoms?


My PTs told me that when the worst of the pain & symptoms are resolved , then the strength will come back in time. I think I read that somewhere too. Seemed to work out that way for me, especially once I got the really good PTs & my chiro.
It did take over 2.5 yrs to get it mostly resolved- part of the problem was the wc system ... denials, change of drs & PT places..

lack of strength is reversible if no atrophy :-)

[sphdallas]

Originally Posted by Jo*mar

Hello & welcome,
What kind of therapies are they using/doing for you at PT ?
And what are they having you do for home therapy?
How is your pain level on average?
What are you most bothersome symptoms?


My PTs told me that when the worst of the pain & symptoms are resolved , then the strength will come back in time. I think I read that somewhere too. Seemed to work out that way for me, especially once I got the really good PTs & my chiro.
It did take over 2.5 yrs to get it mostly resolved- part of the problem was the wc system ... denials, change of drs & PT places..

Thanks for the reply! Scalene stretching, shoulder blade strengthening. I have about 10 exercises I do daily. The pain or rather "discomfort" level changes from day to day. Today it is at least an 8 on a scale from 1-10. My most bothersome symptoms are atrophy and hand weakness.

I am so scared about surgery. What if it doesn't work. YIKES!

[sphdallas]

Originally Posted by boytos

lack of strength is reversible if no atrophy :-)

I definitely have atrophy

[Jomar]

So they aren't doing any pain relieving therapies??
My thoughts are that the pain levels should be down to a 4 or so before moving on to more client active therapies.
{ worked for me anyway, as well as what I have read}

But with the winging, and atrophy it does sound like the nerves are directly involved and you might need a highly trained therapist to find the best treatments for you.

Do you feel like they are just doing a basic PT program for you or do they reevaluate often & readjust if needed, and use your input as well?

things like -
Massage, ultra sound, low level laser, IF stim , heat
trigger point work if you have those..

nerve glides might help for you


how did you acquire TOS?
car wreck or other fall or accident, repetitive work...?

If you had an accident of some sort perhaps there are some misalignments that need to be addressed as well?

[boytos]

myofascial therapy is not so usefull seriously

[Jomar]

Originally Posted by sphdallas

I definitely have atrophy

Are you having any clawing of the hand?

[TraceyW]

hey, not sure how long you have had symptoms for - or what caused them.....but for me things improved greatly when i left the job which made me uncomfortable and often left me with a trememdous feeling of weakness...i worked in an office as an insurance claims advisor - each day was like torture!

5 years since the start of my symptoms and slowly things have improved, with a job as a teaching assistant which offers me great postural flexibility and is not arm/hand intensive in anyway....

I have had lots of pt which focused on posture rather than strengthening, botox in scalenes (just had 3rd round last week) and accepting my limitations and knowing when to give in and rest - these things for me have been essential.

surgery is probably not a great option unless there is an obvious obstruction such as extra rib or other anomoly.

[sphdallas]

Originally Posted by Jo*mar

So they aren't doing any pain relieving therapies??
My thoughts are that the pain levels should be down to a 4 or so before moving on to more client active therapies.
{ worked for me anyway, as well as what I have read}

But with the winging, and atrophy it does sound like the nerves are directly involved and you might need a highly trained therapist to find the best treatments for you.

Do you feel like they are just doing a basic PT program for you or do they reevaluate often & readjust if needed, and use your input as well?

things like -
Massage, ultra sound, low level laser, IF stim , heat
trigger point work if you have those..

nerve glides might help for you


how did you acquire TOS?
car wreck or other fall or accident, repetitive work...?

If you had an accident of some sort perhaps there are some misalignments that need to be addressed as well?

Not sure how I got it. I don't do repetitive work. My therapist gives me TOS exercises and has done some nerve glides. I haven't tried massage or ultra sound therapy. I see a second doctor this week for a second opinion. He is a thoracic surgeon. The first doctor I saw is a vascular doctor. I'm not sure which one is better for doing this surgery. Any suggestions??