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Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie. |
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12-29-2010, 05:32 PM | #1 | ||
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Hello everybody. I have a long messy story so please bear with me.
Over a year ago: I had chronic shoulder pain over a year ago and found out I had impingement of my rotator cuff muscle. After months of Physical Therapy and rest the pain remained. My pain was only present in my shoulder at my rotator cuff and only present if I tried to exercise or use my shoulder. 5 months ago (Aug 10th): After a year of rest and some physical therapy, I finally had surgery in my shoulder. My ortho did a subacromial decompression and distal clavicle excision. A bony spur was removed. He said The tear in the supraspinatus was minor and didn't require surgical repair. He also mentioned very minor damage in my labrum that didn't require repair but just needed to be "cleaned up." He says everything went perfectly and the surgery was a success. I have been following through with physical therapy 3x a week and am doing everything right. But about a month after surgery, I started having a burning/inflamed feeling on the lateral side of my neck. This was soon accompanied by tingling pain in my arms (especially forearm and index finger) I NEVER had these symptoms before my surgery. Nothing even remotely close to this The RC area itself hurts occasionally, but I am moreso experiencing the tingling pain in my lower arm/forarm and really bad inflammation on my neck. (all symptoms are worst the day after physical therapy) I spoke with my ortho and he RIGHT AWAY said "This has nothing to do with your surgery....its incidental...You have cervical spinal issues My ortho said to take the conservative route and have physical therapy/traction therapy done. Im worried and also confused as to why this is happening right after my subacromial decompression surgery. I followed my ortho's advice and had cervical traction done and continued with physical therapy The most frustrating part for me is the fact that I can't diagnose my problem. My Ortho thinks its something spine related. One PT thinks its scar tissue after surgery and overall weakness of scapular stabilizers (even though i have fantastic ROM!)...my newest PT thinks some of my muscles are overcompensating because of overall weakness, and perhaps the muscles are impinging on my nerves?... It has been 5 months since my surgery and Im still having these terrible smptoms all on my right side (same side as surgery): -Pain in my shoulder -Tingling pain in my elbow, forearm, and even fingers -Arm feels like it has poor circulation -Neck feels inflamed/painful on the right side **All symptoms are worse the days after physical therapy** I have been to my ortho, received a cortisone injection, tried cervical traction, active release therapy, and been to 3 physical therapists. After reading about Thoracic outlet syndrome, I am starting to believe this might have something to do with it. At this point I am extremely frustrated and depressed. I just want to know exactly what is wrong so I can pinpoint the problem and try to take care of it properly... |
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12-29-2010, 06:20 PM | #2 | |||
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Since Dr "says" it is spine related - does anything show on xray or MRI?
If no MRIs or no fairly recent then that should be the next step- Imaging of Cervical spine & upper T spine - if for nothing else to rule out the spine as a cause. the delayed pain is often a TOS thing. Does it seem like you have highly skilled PTs - ask for a new evaluation from the top PT there.
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12-29-2010, 06:55 PM | #3 | ||
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I had a cervical MRI done which stated a very minor posterior bulge at c2/c3. My PT and primary care doctor think this is an incidental finding and a spine mri in anyone will find a minor buldge.
But my ortho insists this is the problem and it incidentally started happening a month after the surgery he performed... I spoke with another neurologist and he says it is not a herniation, just a minor bulge. Not sure if this has anything to do with the matter at hand. My ortho seems to think it does, but nobody else does. |
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12-29-2010, 08:09 PM | #4 | ||
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What types of things are they having you do in pt? Many "conventional" therapies like therabands, strengthening, etc make tos symptoms worse. I bet most people here have experienced bad therapy of some type .
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12-29-2010, 08:22 PM | #5 | ||
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Quote:
-Lat pushdowns -Internal rotations -External Rotations -Tricep pushdowns Cable lat pulldowns, Cable rows Weights: Shurugs, bicep curls, serratus push-ups Keep in mind this was all protocol for Physical therapy after my rotator cuff surgery. But my neck/arm symptoms are making me think something isnt right... My newest PT has toned it down much more. Now all im doing is lat pushdowns, and internal/external rotations. I also spend a good amount of time on the electrical muscle stimulator. Unfortunately, I am still experiencing symptoms after therapy.. |
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12-29-2010, 10:24 PM | #6 | |||
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hmm, if it is TOS or something like it...
the bands & weights and such (active on your part) type exercises should wait until all, or at least most, of the symptoms /pain/tingling are resolved by passive means first. What kind of muscle stim? do they use IF stim (interferential (sp) ? or another type? IF stim is nice as it can be set higher without the tingle /zapping of other stims - and if it has the right options/settings it does feel like someone is massaging all over your back - if it used on the back anyway. Any massage? manual trigger point work? *If TrPs are present they have to be released before any stretches or strengthening will help* posture evaluation? forward head/shoulders? passive stretches to open the chest/drop shoulders? my profile has pics of 2 styles of those in my album - they are up in the useful sticky thread also. I'm not sure if there is any time line for scar tissue issues. I think some tend to have it and some don't have problems from it. Sharon Butler's gentle stretches were a real help to me - plus she has really good info about fascia &how it gets damaged and how to repair it. she has a book (in libraries) & a website.
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