When you are up to it - possibly listing & describing your symptoms and avg pain level will give us more ideas for things you can do.

Unless you have something specific showing on imaging or tests, I would ask about (if you need a referral) or locate a highly skilled therapist
- maybe locate a few providers that your ins covers and ask for a referral to one of those.

I don't think I would go with the first recommendation of surgery...and only a part of the rib?? - I thought most take the whole rib now so the stump or cut ends doesn't cause problems later on...

I suggest you read thru our useful sticky thread - it is a like a crash course in TOS & many therapies.
http://neurotalk.psychcentral.com/thread84.html

What is your avg pain level in a day?
http://www.tipna.org/info/documents/...ePainScale.htm

Titus, I sent you a private message. When you log in your name will show up in the upper right corner and it shuld show the notification under that.

[QUOTE=Jo*mar;799132]When you are up to it - possibly listing & describing your symptoms and avg pain level will give us more ideas for things you can do.

Unless you have something specific showing on imaging or tests, I would ask about (if you need a referral) or locate a highly skilled therapist
- maybe locate a few providers that your ins covers and ask for a referral to one of those.

I don't think I would go with the first recommendation of surgery...and only a part of the rib?? - I thought most take the whole rib now so the stump or cut ends doesn't cause problems later on...



My main symptoms are arm pain in the inner part mostly bellow the elbow ans some slightly above. I feel more burning and tightness not numbness. I also have pain in the neck and shoulder (scapula and traps.). In the front part of my chest above and below collar bone it feels tender.

Average pain level is about a 6 but on bad days it is an 8. I'm confused about why some days are better than others. When I went to see the doctor I felt relief that someone believed me but at the same time i don't understand how they can diagnosis TOS on me when all of my tests came back normal? The surgeon was recommending surgery and was saying that physical therapy wouldn't help. I previously have tried pt 3 times but none of the therapist never really knew what they were treating because I never had a diagnosis. I am very confused and I think alot of what I read on line always seems to confuse me anymore. I just feel full of anxiety at his point and not sure what to do. I have seen some many dr.s (neuro, ortho, etc.) who can't find anything wrong with me and this vascular surgeon is the first person to give me an actual diagnosis. I just thought he would be able to give me a rec. for a knowledgeable pt but i was shocked to here about surgery. Again my biggest pain areas is my inner arm but arm problems with ulnar nerve, tendinitis have all been rules out by 3 orthos. Does anyone else have arm pain/ burning/tightness as the major complaint?

Titus: I have and do have all those symptoms. The intensity depends on the day, hour or minute. Like you, I was anxious and nervous with the not knowing what was wrong with me. When I got the dx of TOS, I felt relief but at the same time more anxiety and nervousness, because they said my case was so bad that I was a surgical candidate.

Fast forward a few years - I'm not anxious or nervous anymore. I've learned meditation and coping skills to get me through the tough times. TOS is fluid. Some days are better than others and a flare is just a flare. A new symptom you have today, may be gone tomorrow, or it may cling on for a few. Everything will change. It's just the way it is, for the good or the bad.

Words like what this surgeon told you use to hurt and make me nervous. Now, I realize it's just one opinion. It may be the wrong opinion and I don't need to act on it. With TOS, you will find countless opinions!

Jo-Mar is correct. Find a highly skilled physical therapist. If that one isn't working or you feel something isn't right, find another. You may burn through many during your journey. I'd also find another Doctor who can be part of your team. Suggesting surgery for a short evaluation and removing a portion of a rib? ---------run, run fast!

I know you said you have similar symptoms. Was your arm the worst along the ulnar nerve? I don't have numbness and range of motion is okay. It is hyper sensitive sometimes, achey the next and sometimes tight and cramp forearm. Also what should i look for in a pt and what type of exercise would i expect. Deep tissue and release techniques?

When I was looking for a PT on my own- one that would be very skilled & knowledgeable - I had been though a few rounds of PT already & had read lots of info online and on the forums too.
So I called a few places , but had the best results visiting the PT clinic or offices and asking questions.

Many PTs will take extra or advanced classes and get certified - so they will often have more letters after their name - same with DOs & DCs.

Ask what the extra letters mean if you don't know
Ask if they have studied or treat any special conditions - some study on their own and learn much but no special class or certification

I don't know if any of your other PTs did or talked about any of these-
resolving pain & symptoms - before any type strengthening ( therabands, weights )
fascia and how it plays a role
trigger points
spasms
delayed pain
top rib mobilization/check

posture & posture work is often important with TOS-

Just yesterday my niece was just saying her elbow was hurting quite a bit, she is tall & her shoulders roll forward & she has a desk job and toddlers.
I told her how poor posture & desk work can have an effect on the ulnar nerve - she had no idea about compressions above sending sx down the arm.
She only played tennis once or twice last spring for fun, she was thinking tennis elbow only.

There is what is called a double crush or triple crush -
that is TOS plus an actual ulnar nerve impingement and/or a carpal tunnel = but if so ulnar and/or carpal would show as positive on the emg/ncv testing.

If PT treats at the elbow and nothing much improves - then they have to look at the upper body for the causes - since your MRI is not showing any c spine issues it has to be somewhere in between the c spine & the elbow.
So the neck muscles, collarbones, top rib and pec minor would be the next places to explore.

My range of motion and grip strength is not an issue. I have problems, depending on the time, along all 3 nerves, ulnar, radial and median. The brunt of my issues would be in the neck, thoracic spine, diaphragm, clavicles and an area below my left clavicle. It all ranges from tingling, numbness, heaviness, deep boring pain, vaso-spams and mostly burning.

I did a quick count and I think I'm on my 11th PT. In CA, another TOS friend of mine, found a website which lists PT's credentials. Believe they need to be a member of an association. Like Jo-Mar said, my 11th one had taken classes and levels of education that filled the chart. She specialized in Visceral Manipulation and Myofascial Release.

I've been with her for over a year and I'm going to prove those surgeons wrong. My rib and scalenes don't need to be cut out of me. If I can find the link, I'll see if they have something similar in Michigan.