[boytos]

So here are some treatments that (at least i hope) worth to be tested in a double-blind random trial for TOS :

Local injections for inducing differentiation :

EPO :
http://www.doctorellis.com/Lecture.html - A small dose of EPO reduce by more than 80% the pain of TOS in more than 50% of patients for weeks.

But EPO has some side effects and any other drug that induce diferentiation can work. Here are some suggestions :

Progesterone or pregnenolone Progesterone is on trial for carpal tunnel syndrome, see here :

http://www.biomedcentral.com/content...-7221-5-11.pdf CTS seems to act like NTOS so it seem logic. Progesterone is a muscle relaxant as well (anti spasm like botox)


Others :
Chondroitinase
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1851897/
GM1 ganglioside
http://www.ncbi.nlm.nih.gov/pubmed/11372071
Ginsenoside Rg1
http://www.ncbi.nlm.nih.gov/pubmed/20438804
IGF-1
http://www.ncbi.nlm.nih.gov/pubmed/19802878
L-carinitine
http://www.ncbi.nlm.nih.gov/pubmed/12453625


Local injections anti muscle fibrosis :

The muscle wound healing occurs in three overlapping phases: (1) degeneration and inflammation, (2) muscle regeneration, and (3) fibrosis
In patients with traumatic TOS: type II fibers were atrophied; there was an increase in the average number of type I fibers (78% versus 53% in muscles from control patients); and there was a significant increase (mean: 36%) in connective tissue (muscles from control patients averaged less than 15%). http://ukpmc.ac.uk/abstract/MED/2301718
the changes in the anterior and middle scalene muscles are compatible with trauma, suggesting that fibrotic scalene muscles are an important cause of symptoms in traumatic (& RSI) TOS.
So maybe an injection of these drug can be envisaged :

Hydrogel Delivery of Suramin
http://journals.lww.com/acsm-msse/Fu...Muscle.71.aspx

Myostatin agonist
http://www.jbc.org/content/283/28/19371.abstract
http://www.jbc.org/content/283/28/19371.full.pdf

Matrix metalloproteinase-1 enzyme
previous studies demonstrated that matrix metalloproteinase-1 (MMP-1) is able to digest fibrous scar tissue and improve muscle healing after injury
http://www.actabiomat.org/article/S1...085-8/abstract
http://www.scielo.br/scielo.php?pid=...rttext&tlng=en.
http://www.sciencedirect.com/science...f&searchtype=a
http://www.wipo.int/pctdb/en/wo.jsp?WO=1997014420

Decorin
Using decorin, an anti-fibrosis agent, to improve muscle recovery after injury.
Our findings indicate that further improvement in the healing of muscle lacerations is attained histologically by the combined administration of IGF-1 to enhance muscle regeneration and decorin to reduce the formation of fibrosis.
http://onlinelibrary.wiley.com/doi/1...10436/abstract
http://www.sportsinjurybulletin.com/archive/decorin.htm
http://ajsm.highwire.org/content/29/4/394.abstract

These drugs may improve traumatic arterial TOS.


Oral :

Serrapeptase

An old study found for CTS. It is claimed on the internet that Serrapeptase help for scar tissue so maybe for tos too but i have not find real study.

Here the study :

This study was planned to assess the response of Serrapeptase in
patients with carpal tunnel syndrome (CTS) ====> Same mechanism as TOS !!

Twenty patients with CTS were evaluated clinically. After baseline
electrophysiological studies, these patients were given serrapetase10
mg twice daily with initial short course of nimesulide. Clinical and
electrophysiological reassessment was done after 6 weeks.

Mean age was 43.9 years with male to female ratio of 1:2.33. Sixty
five percent cases showed significant clinical (13/20) improvement which
was supported by significant improvement in electrophysiological
parameters. Recurrence was reported in only four cases. No significant
side effect was observed. ===== > 9/20 were saved with no reccurence and the 4 case can try again + very rare side effect not like surgery !!

CONCLUSIONS: Serrapeptase™ therapy may proved to be a
useful alternative mode of conservative treatment. Larger study
may be further helpful to establish the role of Serrapeptas in CTS. Don't know how but it work ! Digest scar tissue ? need to be explain

http://www.ncbi.nlm.nih.gov/pubmed/11225219
http://neurotalk.psychcentral.com/thread135530.html


Additionnal information about result of EPO :

In a very recent study, it is show that 75% of all TOS have in addition pectoralis minor syndrome, contributing to the symptoms. So it is possible that the results of epo-like injection can be enhanced by an additional injection on pectoralis minor. Pectoralis minor syndrome is totally reviewed in this study.
Link :
http://www.ncbi.nlm.nih.gov/pubmed/20471786