I haven't seen any improvement with PT in the last 2 weeks. Shouldn't you see an "ounce" of improvement since then? This shoulder pain isn't going away and I am resorting to a muscle relaxer just so I can move my dominant arm. I know when I go back to the dr that I will encouraged to have the surgery. Can you get the white hand with neurogenic TOS? I don't think I can continue with this limited mobility and pain for much longer when I worsen by the day.

What concerns me the most is how badly I scar. I've been told that my scar tissue is awful from some abdominal surgeries. This alone makes me NOT want the surgery. My shoulder blade is down around my arm pit causing extreme pain. I've been told by the PT's that my issues are nerve and muscle and difficult to relax the thoracic area while building up the shoulder at the same time. Have any of you been this royally jacked up as me?

Are you saying you have only been in PT for 2 weeks total? Hate to say it but you are looking at a long haul to find some signs of improvement. Surgery is not a quick fix, probably a longer road then if you can fix it with pt in the begining. Is your pt trained to treat tos? or are you dealing with someone unexperienced in it? a toser in the hands of the wrong pt is dangerous and can make you worse than before.
White hand is a common sign of neuro tos.
Please consider surgery as a last resort unless it is life threatening.
(BTW im at my last resort, surgery next week )

What kinds of things is the PT doing for you , or having you do?
What is your avg pain level?

You don't have frozen shoulder do you? If not, try to keep it moving gently so it doesn't freeze up - that is a whole other bag of problems.

I found this pain scale that describes the levels nicely

[Mankoski Pain Scale

Andrea Mankoski devised this pain scale to help describe the subjective experience of pain in more concrete terms to her doctors and family. Please feel free to use it and distribute it with attribution.

0 - Pain Free
1 - Very minor annoyance - occasional minor twinges. No medication needed.
2 - Minor Annoyance - occasional strong twinges. No medication needed.
3 - Annoying enough to be distracting. Mild painkillers take care of it. (Aspirin, Ibuprofen.)
4 - Can be ignored if you are really involved in your work, but still distracting. Mild painkillers remove pain for 3-4 hours.
5 - Can't be ignored for more than 30 minutes. Mild painkillers ameliorate pain for 3-4 hours.
6 - Can't be ignored for any length of time, but you can still go to work and participate in social activities. Stronger painkillers (Codeine, narcotics) reduce pain for 3-4 hours.
7 - Makes it difficult to concentrate, interferes with sleep. You can still function with effort. Stronger painkillers are only partially effective.
8 - Physical activity severely limited. You can read and converse with effort. Nausea and dizziness set in as factors of pain.
9 - Unable to speak. Crying out or moaning uncontrollably - near delirium.
10 - Unconscious. Pain makes you pass out. ]
http://www.wemsi.org/painscale.html


If you are in pain and having very bothersome symptoms, I really feel that there should be NO strengthening/building up PT work at all.

The focus should be on pain reliving therapies using ultrasound, massage, manual trigger point work, IF stim and/or even some low level laser.
Passive posture work is good also.

If they aren't doing any of these at all for you, I wonder how experienced they are with this sort of syndrome.

I was in the work comp system and had to go thru many PTs and places before finding really good ones, also my chiro was very good with all those PT type modalities- plus the adjustments helped too..I didn't find him until a year into it.

Due to the work comp "rules/red tape" and having to work light duty for a few months (PT could not offset the driving and trying to work & do ADLs at home) it took about 3 months for the acute pain to resolve, at 5 month mark to see some measurable relief with very light uses and about 2.5 yrs for normal activities to not set off symptoms. As best as I can recall anyway, mine started in 03, so it's been awhile ago.

I will call the PT tomorrow. She has had experience. She has been doing massage, stem, and trigger point. The exercixes are for helping relax the thoracic area, but at the same token I have to slowly build up the shoulder to get it In the right place. The upper trap is useless right now. Doesn't know what to do. Nothing exercise wise is working. You feel like a loser when you do an exercise for a dew reps and then must stop b/c of the numbness. I'm just way discouraged.

I had the chest xray, cervical spine xray, and MRI all come back normal. Scalene and pec minor block did help to relax, but this is when all the shoulder Pain began to rear it's ugly head

rj: Creepily strange you mention abdominal surgery and scar tissue. You may want to look into prior surgeries, even in the abdomen, as a reason for your TOS.

PT for TOS can't be measured in weeks.