[343v343]

I am 33M and have been hitting a wall in finding out what is wrong with me. First symptoms were my 4th and 5th finger getting cold (physically) while working on a computer on my right hand with no real other issues.

Over the course of the last couple of months, it has spread to both hands getting cold, even when not working and all fingers getting cold as well. I can get them warm, but it takes effort. Once they're warm I can keep them there until the next episode of them getting cold again; usually the next day of work.

It has also progressed to tingling throughout both arms, and as of this weekend it seems as if my arm gets tired and dull when I hold it outstretched (for example high on the steering wheel).

Had an EMG test done which indicated some sort of nerve disturbance in my neck and was referred for a cervical MRI. Also had minute signs of carpal tunnel in my right hand, but was advised it was very slight.

My back, shoulder blades, trap muscles and neck seem to feel like I have a sunburn although I have not been in the sun. It's just a burning sensation throughout. Also present up and down my back and random intervals.

I have also had both hands become numb while sleeping which is scary to say the least. All of this seems to get progressively worse by the week which has me quite concerned.

I can't see my neuro until the 15th to go over the MRI, which is leaving me in a state of worry. I am thinking my more immediate concern might be vascular related and my fingers and hands going cold. Should I be panicked? Or is coldness related to neuro stuff as well?

I also have bad TMJ problems and know tingling can be a related symptom, but to my knowledge it is a symptom because of thoracic related issues with muscle compression.

Have been working on posture related improvements but have always tried to maintain best ergonomics where possible.

The rapid onset of symptoms has me worried as it would seem reading some of the posts here, symptoms usually start in one side and gradually. I also have no history of trauma to the neck or vehicle accidents.

Could really use some input or insight. If it's not TOS, any other things I should consider? I'm in the Los Angeles area, for what that's worth.

[Jomar]

Hello,
For the MRI & report often you can ask for a copy of the report as well a as copy of the imaging on a cd. The place I got my MRI I had to buy copies of the actual films later , I didn't know it was a option to ask at the time, they didn't do the cd thing then.
It's just handy to have your own copies in case you want to have another dr or chiropractor give an opinion.

Plus you can also look up any medical words and descriptions ahead of time and be better informed with questions to ask the dr during the appt.

Up above the main TOS page is our sticky threads on Drs & PTs - you may want to see which TOS drs are near to your location in CA.

Your symptoms sound like they could be TOS , but it's good to have MRI's and the other tests just to help rule out anything else.

Keep reading the other posts and look thru the sticky threads.

TOS is often so different for each of us, sometimes we have to explore ourselves to find what helps or not, but this is a good place to get ideas & tips, and also on surgery if it comes to that point.

Make sure your desk/computer set up is as ergonomic as possible, be aware of your posture, take breaks to walk & stretch and get the blood flowing again.

Oh is the air conditioning blowing right on your hands or neck?
That is often a big aggravating factor for RSI as well as TOS.

[343v343]

Originally Posted by Jo*mar

Your symptoms sound like they could be TOS , but it's good to have MRI's and the other tests just to help rule out anything else.

Thanks for the quick reply. I guess I am unsure of what to do next. Can I just call up one of these doctors in the sticky and ask for a consultation? Do I need my insurance approval beforehand? I actually do have the MRI files on a CD, I thought enough to grab a copy. But who would I take to interpret them? If it were more cervical spine related, would that mimic the symptoms?

I am sure repetitive strain definitely aggravates my symptoms whatever they are. So I have been extremely mindful of doing everything I can to maintain good posture throughout. I just find it odd that I'd have bilateral symptoms, so uniformly, so quickly. Is that common?

In reading the posts and stickies, it seems like an overwhelming majority of posters have gone down the surgery path. Yet other places I look at, it seems articles suggest only about 20% of those who have this require surgery. Is it just the worst cases who post regularly here? Seems that for the most part surgery is only a temporary fix or none at all.

Confused and scared beyond words.

[343v343]

If I didn't have TSO, any other ideas for what to look for? Could a pinched nerve really cause cold fingers and hands?

[Jomar]

Is the written report on the CD or only the images?

One member put together a testing info list-
http://neurotalk.psychcentral.com/post720246-1.html

Some have all that testing done, and some don't need it all.
Generally the more complicated your symptoms & case, the more testing you will need.

A few of us are carefully getting along with some mild to moderate recovery without surgeries by focusing on different types of self-care, what ever works for each of us...plus some pro PT or such at times.
Like chiropractor, bodywork, yoga, posture, massage, trigger point self care..

Some have surgery and do recover well, and they just don't post much anymore. Some have surgery and still have some amount of pain.

Hopefully others will be along to share how they got in touch with the various TOS specialists, I have avoided that so far.


The useful sticky - http://neurotalk.psychcentral.com/thread84.html
is full of all sorts of info

and post #1 has many of the TOS drs websites as well as medical sites & alternative care - http://neurotalk.psychcentral.com/post388-1.html

Nerves can make for odd sensations like hot/cold, but also you need to find out if it is blood flow caused or not. This site shows a simple test you can try, just to get an idea if blood flow is compromised or not.Also a dr or PT , DC will probably do those tests too.
a certain % of normal population can have the blood flow stopped also, so it is not a for sure dx tool.
http://www.nismat.org/ptcor/thoracic_outlet/

[343v343]

CD has images only but my GP called today and got the radiologists' report. MRI came back completely normal. I guess that only points more towards the TOS.

I did the "stick em up pose" and both my arms began to tingle extremely quickly. I'm guessing that is not a good sign.

I am self employed and work on a computer for a living. No worker's comp either or eligibility for disability. Am I really going to have to quit working? Man, this feels like the end of the world if so.

How do people live with this? I am only 33 and to think I am going to suffer with this forever?

[343v343]

But REALISTICALLY - given you're obviously a veteran...

1.) How many people recover and are able to work again?
2.) How many people recover and live a decent life?
3.) Will I be bedridden and reduced to pain killers the rest of my life?
4.) How do people live if they can't work? (I have no workers comp).
5.) What is the realistic % of people who avoid surgery?

I assume you are non surgical treatment

[Anne4tos]

343: To me and I'm not a Doctor , it sounds like you could be in the early stages. Considering your job, it's most likely posture related with poor ergonomics.

Feeling as if you had a sunburn is one of the symptoms I remembered in the beginning as it progressed. I kept looking in the mirror to see if I was red.

Most people recover, are not bedridden, do not live a life on pain killer, etc. Since this came on rapidly (I can relate), I would get to an excellent PT ASAP. I would also have your work station analyzed by a professional in ergonomics.

I did not get to a PT soon and when I did it was made worse. This is a story all to often shared. What part of CA do you live?

[Jomar]

I agree with Anne.
Many that recover don't continue to post.

And I totally agree that you seek out "quality, expert & advanced" physical therapist, body-worker or chiropractor ( one that will use PT modalities as well as adjust if needed) to get you started on proper rehabbing.

But if you feel treatment is not working or they don't adjust to your needs or if pain increases, move on to another place or therapy.
Sometimes the avg PT will just do a one size fits all plan and it does not work for many w/ TOS. The resistance bands or weights too soon can mess you up, be aware of that, go with your gut feelings on when to move forward with those and don't let them push you too fast.


Also read as much as you can here for tips and check out the google /you tube videos for thoracic outlet syndrome as well as the tips ideas you read about here. those videos are pretty good at giving an idea of how the various therapies are done.

Self care and consistency is very important.

oh I was going to mention looking into a voice recognition software to help with your work, at first sometimes what is really needed is a break from the computer keyboard & mouse. There are specials on dragon naturally speaking quite often and prices on the net can be compared easily.
or if you have a Mac or Windows 7 or even Vista I believe - VR is built in - you just need a quality mic & a good sound card for decent results after you set it up.

Generally there is not a "quick fix" but a reduction and fading of symptoms if all goes well.

Mine took 2.5 yrs to get to 75% of normal, much of that time was wasted due to the work comp system, and that I was only beginning to learn about TOS a few months into the acute stage of my injury.
(assembly work)

[343v343]

An update:

Went to my first PT appt. today and they seemed to agree it was indeed TOS. They were able to replicate symptoms and felt a decreased pulse in certain positions on both arms. I'm a little overwhelmed with the realization of having this, and I am mentally telling myself I want to do anything I can at all costs to avoid surgery.

The PT has experience with TOS patients and seemed fairly knowledgeable about the condition, which is a positive. First appointment didn't really involve much other than a "get to know you" session combined with some moist heat and stretches. I was also taught about breathing more from my diaphragm to decrease upper chest movement. Feels a bit foreign, but if that's what it takes. I have also begun doing the corner stretch, often for my chest muscles.

I know I am being somewhat insecure in asking, but are both of you able to live somewhat normal lives? I just have this horrible outlook that I will have to cease working, eliminate physical activity or active lifestyle. I have 6 appts. total scheduled for the PT, so I am trying to absorb everything I can in progressing on my own after treatment.

I know it's probably good I am catching it early. I just want to do whatever I can to ensure I can maintain a normal life.

Thank you both for all of your input. I am in the Orange County, CA area.