I share my researchs about TOS for free, on 11/12/2010, hope you like it.

RSI induced TOS :

Please suscribe to the *edit* for full discussion and for all my others researchs.

Based on the work of doctor Ellis, studies of RSI TOS's scalenes and RIF studies by Dr.Delanian and some others studies from some others doctors

Before starting...
EPO and heparin experiences :
http://www.doctorellis.com/lecture
TOS is caused by fibrosis of scalenes :
http://www.ncbi.nlm.nih.gov/pubmed/2301718


I- What is NTOS by dr ellis
II - What is RIF and effective treatment
III - TOS and RIF
IIIb- Neurogenic hypertrophic muscle, a role in TOS ? (important for VTOS)
IV- Treatments for TOS
IVb) Theory about costo-clavicular syndrome



I - What is NTOS by doctor Ellis


Poor posture + repetitive motions or trauma ---- > Neuronale inflammation ----> release of pro-inflammatory citokynes + (oxydative stress ??)----> Touch nerve and adjacent muscle ----> atrophic fibrosis around nerve (+ neurogenic muscle hypertrophy) . Then more trauma make the process spreads on the system and the symptomes goes worse (double crush injury). Sometimes fibrosis/hypertrophic muscle constrict blood vessel depending on morphology and location. This can happen anywhere.

Interesting abstract :

"What do we know about this mechanism? It must be primarily neural involving sensitized nervi-nervorum and communicating with local mast cells, monocytes, and fibroblasts to participate in the micro-inflammatory process that drives the pathology. This involves not only inflammation, but also the accompanying growth factors, which affect nerves, muscles (hence, the frequent scalene hypertrophy), existing fibrosis, as well as irritating nearby nerves, such as the vagus and, ultimately, the spinal cord (not to even mention activating the local innate immune response) to produce the insidious, cumulative, and devastating symptoms typical of NTOS."


Finaly fibrosis and constriction of nerve may start a de-differentiation process were the nerve return to immature.
That explain why there are no objective test for NTOS, because no damage or just a little.

Epo, a drug that induce differenciation give 80% relief on more than 50% people for weeks.

So doctor ellis call this "Neuronal inflammation-induced fibrosis". He say it is like post-operative fibrosis(1).





II- What is RIF and effective treatment

It is radiation induced fibrosis.

RIF is like TOS's fibrosis !

I find that RIF is reversable, trials are very impressive.

http://jco.ascopubs.org/content/21/13/2545.full
http://www.google.com/url?sa=t&sourc..._dG7MCH9oLYy3A

It is today largely accepted.

It is like the TOS fibrosis : Very active atrophic fibrosis with citokynes So RIF = TOS's fibrosis ? It's a good possibility.

About dr delanian :
Dr delanian made many studies about fibrosis, specialy RIF, she also write many officials book. In one other study, she show that Post-operative fibrosis is reversed by Pentoxifylline and Tocopherol(1): http://www.ncbi.nlm.nih.gov/pubmed/18996041
I have found many incredible testimony on forums.





III - TOS and RIF

Rif is cured, so maybe TOS too, so we know compare these conditions.

RIF :

From a clinical point of view, chronic radiotherapy damage is a dynamic process that combines atrophy-contraction and connective hypertrophy-fibrosis in the same volume of damaged tissue.

http://jco.ascopubs.org/content/21/13/2545.full

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 (scar tissue) (muscles from control patients averaged less than 15%)

http://www.ncbi.nlm.nih.gov/pubmed/2301718

Near the same ! For details, look studies and docterellis's experience.




IIIb- Neurogenic hypertrophic muscle, a role in TOS ?

At least for vascular TOS; but maybe for all TOS;
(Sorry for police problem, the forum don't work well)

TOS may be neurogenic hypertrophy muscle AND spreading fibrosis on nerves.

What is neurogenic hypertrophy :

http://www.springerlink.com/content/t5v641820205812p/

The cause ?

chronic increased tone by excess of activity or motor neuron stimulation or spontaneous electrical stimulation of myofibers

It is reversible :

Once the scalenes are removed, abnormal atrophy automatically return to normal !
After tenotomy there is a reduction of type 1 fiber representation, selective atrophy in the type 1 fiber system (atrophy factor, 0.66 ± 0.24), and increase of type 2 fibers

http://archsurg.ama-assn.org/cgi/con...ct/121/10/1141

The question is : Is neurogenic hypertrophy muscle a part of TOS ? Or TOS is just a fibrosis so vite+ptx only can work ? i don't know.

Anyway if yes, stopping increased tone or motor neuron excitation will reduce symptoms at least.
If neurogenic hypertrophy muscle is part of TOS, carmabazepine may improve it, more than other nerve bocker.





IV : Treatments

- Treatment for fibrosis

Pento + vitamine e
or
Superoxide dismutase (SOD) alone http://www.google.com/search?hl=en&c...=&oq=&gs_rfai=
http://www.lef.org/magazine/mag2005/...ort_sod_02.htm
or
Superoxide dismutase (SOD) + Pento
or
maybe omega3 hight dose (>2,4g) +Vitamine E http://www.springerlink.com/content/v0g15522w0511653/ :
or
Heparin (maybe more powerfull than pent) + vitamine E
and

+ Anti-cytokine lifestyle
+ Eventually decorin therapy to prevent recurrence
For 6 months - 3 years



- Treatment for neurogenic hypertrophy muscle if it has a role in TOS

It may have role for all form of tos at some points

Once the scalenes are removed, abnormal atrophy automatically return to normal ! This suggest an implication in motor norons and excess of activity suggested by fiber type I dominance.
So a therapy of Phenytoin sodium may reverse it. Carmabazepine may be helpful too !
At least for RSI NVTOS.
http://www.ncbi.nlm.nih.gov/pubmed/6830473


IVb) Theory about costo-clavicular syndrome

Addionaly, fibrosis of scalenes may make them spams (part of neurogenic hypertrophy tissue), so the first rib is elevated. Add to this internally rounded shoulders by pectoralis minor (75% of NTOS have pectoralis minor syndrome from a recent study) and it can additionnaly compress artery, vein and nerves, depending on morphology, on the costo-clavicular space, so there are three space : scalene nerve only with fibrosis and nerve involvement, costo clavicular for vascular & neuro and often pectoralis minor, sometimes alone.

Pt : More space on costo clavicular
Relax scalenus

I think Reversing fibrosis with long terme anti citokyne + antioxydant and inducing differentiation, and Phenytoin therapy/carmabazepin need to be seriously examined.

Florian.

I wonder if any of the ones that have been to tons of Drs have seen or read about any of these things - i haven't seen any mention of these therapies at all here in the past.

Some have gone to top TOS doctors and I don't recall anybody posting about this stuff, unless it was because they went to the top TOS surgeons?

I checked a few of the dates - I don't have time right now to look at all of the links - I see the dr Ellis lecture is from October 23, 2009 - so that is fairly new.

many of the older TOS members here probably hadn't seen that info unless they are still searching for articles --

thanks for finding & posting those.

You might post the date or year written so everyone will know that it is "new" and not something they saw long ago.
Might get more readers that way.??

I wonder if any of the ones that have been to tons of Drs have seen or read about any of these things - i haven't seen any mention of these therapies at all here in the past.

Because i have personaly done these researchs

I have sent my ideas by email to expert TOS like R sanders, they all said "Very interesting, i keep it in mind thanks" That the exact mail of RS lol

Anyway i have tried

How did you have time to research and learn complicated scientific information as a 20 year old accounting student? It's unbelievably impressive, since you are new to tos too.

08-10-2010, 09:42 AM #1
boytos
Member

Join Date: Aug 2010
Posts: 136
My Mood:
New to tos : what can i do ? :'(
what do i have exactly ?

I have felt pain on my hand sometimes at work (i am an accouting student) and thinked it was nothing more than fatigue.

In december it was more painful so i went on the doctor :
He say it was a postural problem because my hand was like red - violet and then he make my shoulder go in a good position and the symptome improve in the same time.

He say it was just a postural problem, but some symptom still persist and no not improve with time so i checked the internet and knew i had TOS

Confirmed by an doppler exam with sound, he say it was a TOS maybe du to fibrous band somewere from postural cause... I have some

Sometimes i heard a pulstaile tinnutus. And sometimes a big noise like "TCHIK" in my head or ears when i move after a long period of sleeping in the same position. I have now some tingling in my hand (only) and pain when i use computer like typing.

Im only 20. What can i do now ?

Because i'm 1 year off account, and i think i stop this for life, yes TOS changed me

and because i think if webbot can read the futur, i think we can advance is comprehension of TOS with internet

For the rapidity, i'am a type 1 personality

And it's all theory

Scalenes change are not clear to me, i have sent email to some contact, i keep you informed.