Thanks to all that have answered my questions so far.

I got the results from my brach. MRI on Friday - everything is looking pretty normal so this has ruled out TOS for me (although I still have rock solid scalenes for no apparent reason).

It confirmed mild prominence of the C7 transverse processes (as seen on an x-ray too) but no evidence of cervical ribs or calcified bands etc. Also states mild symmetric prominence of the cervical nerve root sheaths at each level but states this can be a common finding and no need for concern as no nerve root thickening etc.

So, you knowledgable lot, does this totally rule out the C7s being any kind of problem?

I have been advised by the neuro to see an anaesthetist to try and have diagnostic nerve blocks to see if we can isolate where the problem is coming from in terms of nerve disturbance - could it still be the C7 causing something like Occipital Neuralgia or would that be located elsewhere?

Thanks again everyone,
CindyCB

Many of us w/TOS tend have fairly normal MRI's. This may point to more soft tissue causes vs an obvious cause showing on the imaging.

A normal MRI does help to rule out c spine & other obvious bony anomalies that could be a cause of pain/symptoms. like extra cervical rib or large bony structures.

"mild prominence of the C7 transverse processes"
does that mean on both sides?
are your sx on both sides?
I kind of wish they would say the sizes of what you have compared to what a "normal" might be...

Quite a few in the past have had blocks to help with diagnosing & locating the area of concern.

If the C7 transverse processes are longer then that of the T1, then they are considered elongated.

From my experience the Elongated transverse processes contribute to the symptoms but are not the underlying cause. The scalene muscles themselves are usually the cause.

Thank you for the replies - Jo*Mar, what you say about the nerve blocks is very encouraging and gives me a little hope (not easy these days).

The C7 are indeed longer than the T1 - I was told it was 'minimal' and looking on the x-ray to me it looks like a good few mm but it's hard to say as the x-ray quality is very poor.

They are elongated on both sides but the right is slightly bigger plus my neck curves to the right which makes it worse too. I can actually feel a 'click' of what feels to be bone on bone in my right shoulder, around that area... that can't be right can it?

This happens when I wake up in the morning and when I have been sat typing or crocheting etc.

I'm wondering if this small problem is agrravating my tight shoulders and they in turn are crushing some nerves... with any luck something like a nerve block could help with diagnosis?

CindyCB

I don't know if they (bones) would actually be able to click- usually they have muscle, tendon and other tissues between them, I think.
That would be a good question to ask PT or DR about.

I did come across this, there is probably more like it -
http://www.nerveblocks.net/tutorium/...ection=content

My understanding from talking to my doctor is that the primary cause of TOS is something called perineural fiberous. which is very small, otfen to small to see on an MRI. The other common causes listed (which are easier to see on imaging) are often really secondary causes that only start to be a problem when you have the first problem.

Essentially the perineural fiberous is scar tissue around and in your nerves has had abnormal nerve growth into it. This cause your nerves to not be able to move normally and causes them to be stretched when they should not be,

That say, any nerve blocks offered can help isolate problems, it a good idea to do them.

In my case, the ortho though my reflex problems (in my hands) were from the spine (on exam before an MRI) but the reflexes became normal after a special brachial plexsus block. The neck MRI was pretty normal, just small nerinations typically of middle aged spines.

In my low back the spine nerve blocks made it really clear what the three causes of my low back pain were. My spine is pretty crumbled there so it's helpful to know what exactly is causing the problem