Hi all,

I am comforted and relieved to find this support forum. It's disheartening and frustrating to feel weakness and in pain every day, and no one can see why it hurts. I'm a 24 year old female.

Anyway, I believe I developed TOS from repetitive strain at work. I used to work in a mental health facility, where we had to restrain teenage girls multiple times a day. Last January and February, our restraints increased to over 40 in the month, and it was at the end of February that I started to notice my symptoms.

Fast forward to September 2011, and I feel like I've been around the doctor block. I'm fortunate to live in Boston, MA, where we have so many great doctors and medical institutions. I've been to my PCP, a physiatrist, an OT, a vascular surgeon, a neurologist, and a thoracic surgeon. After these folks and lots of tests, a diagnosis is still inconclusive:

• Xray - no extra rib
• EMG - no abnormalities
• nerve conduction study - no abnormalities
• PT- my strength decreased by two thirds in five weeks, so it was not helpful
• CT scan - no abnormalities
• vascular study - the only test that indicated loss of circulation

I'm now awaiting to hear about Botox injections into four muscles (two on either side). MGH's Dr. Donohue is working to get clearance from my insurance company.

In the meantime, I continue to have daily struggles. My pain and weakness are sporadic, and there are now two days alike.

• • When hands/arms are in a raised position, hands become pale and appear to have lack of blood flow
  • Weakness in grip and strength
  • Aching in hands and arms (feel “limp”)
  • chest pain
  • elbow pain on both sides (more often left side) in the notch between the two bones on the inside of the elbow
  • “odd” sensations in pinky and ring fingers on my left side (burning, tingling)
  • Pain where collarbone meets shoulder
  • Tension and tightness in neck and shoulders (frequent)
  • Swelling of hands – veins “pop” out (a few times a day)
  • Overall loss of weight and sometimes lack of appetite

Glad to find everyone here.

Take care.

Hello & welcome,

Are you still working full duties?
In the past we had many nurses that got TOS from catching falling or otherwise handling patients , so that kind of injury is possible..

Do you feel the PT was highly skilled and adjusted to what you needed & how you responded each session?

With TOS we really need to have an expert PT that will listen and adjust session each time, and often it will take time... not a 8 weeks only and done thing..

I had my best results with a chiropractor that does the upper cervical adjust as well as myofascial work along with manipulations and other PT type modalities.

Things to learn about..
Top rib mobilization
trigger points
posture = forward head/forward shoulders
myofascial work= sticky tissues/restrictions /adhesions...

check out our sticky threads up near the top of the main TOS page , tons of info

Hi there, Jo,

I really liked the PT - she has treated many patients with TOS in the past, and I felt confident in her abilities. The other specialists I've seen seem to conclude that my symptoms are not allowing PT to be helpful at this point.

Hopefully after I get the Botox injections I will be in a place where body is receptive to PT.

I have not read about top rib mobilization or myofasical work before, but I certainly will try to learn more.

Thank you for the warm welcome!