Folks,

I'm wondering if I'm a good bet for TOS. I've been battling shoulder and now elbow pain for a year + and have seen several orthos, physiatrists, chiropractors, etc. with no help or relief.

Here's a little history:

* Initial Injury: About a year ago, I felt something "give way" in the posterior of my shoulder doing a heavy lat pulldown. I felt like it was a muscle pull in my trap area. Didn't think much of it and ignored it for 2-3 months and just tried to deal with my posterior shoulder pain.

* MRI Results: Got an MRI which showed posterior partial tears in my capsule ligaments. Orthos didn't think much of it.

* Original Diagnosis: "Scapular Diskinesis." Something that PT should solve they said. Given a very low "significance score" in terms of the injuries.

* Physical Therapy: Made it worse. New burning type pain on my scap and armpit joined the party. This pain seemed to seep into my upper arms at times. I also felt some wierdness in my fingers. This drove me to get both a cervical MRI and EMG.

* MRI/EMG Results: Zippo. As a result, Neurosurgeon's continue to boot me out of their office.

* New Symptoms: Twitching muscles around the scap. This then blew up all around my body (after searching the internet and finding that this is a symptom of ALS...great).

* New Symptom Most Recent: Severe, ACUTE elbow pain. I was about to have arthoscopic surgery on my shoulder and all of a sudden I couldn't bend my right elbow without getting excruciating, debilitating pain. Funny though, it's fine if I have my elbow at my side, but if my elbow is positioned away from my body and I bend the arm...BAM! This pain petrifies me.

* Latest Diagnosis: Went to a shoulder specialist at Beth Israel in Boston and he didn't think anything was structurally wrong with my shoulder and thought my issues were more nervy. Now I'm on neurontin and seeing some improvement in the elbow issue.

I've done some research online and it seems like my initial injury is kinda in the same location where the thoracic nerve is located. Also, this nerve innervates the serratus anterior muscle which helps keep the scap in place...and my scap has proved to wing? I've also read that the "burning" symptom is a sign of TOS. Other alignments: EMG sometimes shows normal, TOS often mimics rotator cuff injuries.

Does this at all lign up?

Do any of you share the same symptoms I have?

Who the heck will listen to me? A Neurologist?

The only thing that doesn't line up is the sudden elbow pain.

I need to investigate because I'm going insane.

If you have any insights please help.

Thanks.

Ky

besides the pull/injury while exercising - do you have other possible factors?
like what kind of job = desk or other static head/arm forward type postures, repetitive, reaching up/out/overhead??
previous whiplash or head/shoulder falls or sports injuries?
hyper mobile/ lax joints?

If you read thru our sticky threads above- start with post #1- those will help you to learn about TOS form many top TOS info sites & various therapy info sites also.

JoMar,

Thanks for the reply.

I think it's important to know that a) I'm a 42 year old male, and b) for the a year prior to my injury I was engaged in an intense bodybuilding program. We're talking about a great potential for repetitive / overuse activity. Especially for somebody at my age. We're talking all kinds of push and pull movements with LOTS of weight -- weighted pullups, weighted dips, vertical and horizontal pressing, you name it. And I did the same routine for months.

Previous injuries includes one: I herniated a lower lumbar disc about a decade ago.

As for job, I'm a marketing professional who is tied to a laptop. And I work at home quite a bit. And you guessed it...sit on a couch...on the phone...horrible work ergonomics. So this doesn't help.

The bottom line though is that this horrible journey started with that latpulldown injury. It started as a posterior, right shoulder discomfort and has just blown up into something that not only provides discomfort with certain movements (i.e. pressing, internal rotation), but also several nervy symptoms (i.e. burning scap/armpit/upper arm, muscle twitching, sharp elbow pain).

I've searched high and low for a diagnosis that fits and TOS seems to fit my comination of Injury origin + scap winging + burning / nervy symptoms + symptoms that mimic rotator cuff damage (and two orthos have told me "your shoulder is not causing your pain").

So here I am.

I'll read the stickies for sure.

Again, if this sounds familiar to anyone or have any feedback fire away.

I'd also like to know who is best at diagnosing this type of thing? Is it a neurologist or an orthopedic Dr? Or somebody else?

Thanks.

KY

I will submit some of our symptom paragraphs.

Also, my paragraphs on getting treatment. TOS is one of the hardest illnesses to identify and then treat.

God bless you. Check the other threads I'll bump up.

Thanks Tshadow.

I've been reading a lot of the literature in the stickies and while I'd say I'm not a dead ringer for TOS, there is A LOT in alignment with my current situation.

What's aggravating is that it seems that there are many alternative diagnostics (MR Neurography, thermography, MRI angiogram, etc.) that could be available here.

I need to keep reading, but I don't think I've talked to the correct medical professional about a nerve specific condition. The neurosurgeon only cared about the spine and the orthos seem only concerned with what's going on within specific structures. This seems to fall in the cracks.

One finding that I find in aligment is that it seems like the pain first starts above the collarbone then moves to the shoulder, then down the arm and finally to the fingers. This is dead on for me. That initial lat pulldown caused what I thought was a trap pull (or something up there), then posterior shoulder pain, then radiating scap/armpit pain followed by upper arm pain, and now sharp elbow pain. And I've had intermittent "tingling" in the fingers every now and then.

I don't want to force fit this, but it seems to be in the ballpark. At minimum, I feel like it's deserving of some advanced nerve issue diagnostics. I just need to find the right person for the love of god.

Much thanks here. This is a great board.

KY

Try to locate an advanced or knowledgeable Dr or PT or even a expert chiropractor...some find help with these other methods/modalities, and some don't.
I sure did, got more help & symptom relief than any of the MD's I went to, same with the rookie PTs, stay away from any beginners or those that use a one size fits all approach.

You need to find ones that have studied more on the soft tissue/myofascial/ alignment parts of the body.

Body-workers, usually advanced ones might be of help also.

The whole area involved is so complicated it takes someone with a very inquisitive mind to sort out all the factors that can be at play.
And it takes time to resolve all the bad stuff after you find some good help.

So don't get too impatient if things take awhile to improve, as long as it begins to feel like you found some good help and small steps are moving forward, that is a big plus.
any steps backward need to be addressed and figured out why.

Well, my chiropractor has already shoed me away which is disappointing. Been with him for years and based on what I'm describing he doesn't think he can help.

It's hard to be patient when a year passes, you're still in the same boat, and there's no prognosis of things changing.

Are there any resources for finding this kind of "curious physical therapist?" I've worked with tissue people of all kinds and there seem to be many all over.

Seeing my surgical ortho and a neurologist tmrw. Trying to go in with a plan of attack so these people will actually listen.

Thanks.

KY

I'd suggest seeing a physiatrist or Physical Rehab Medicine specialist. They conduct EMGs/NCVs. It was a physiatrist who diagnosed my TOS. I had shoulder and have spine problems making me a complicated case but he tackled the most obvious first => TOS. My experience with the physiatrist was he acted like the center of a wheel, managing my care with several different providers. My chiropractor dismissed TOS as a possibility when I mentioned they were looking into it as a possibility.