Hi, I was just diagnosed with TOS and a Cervical rib on my right side. I am contemplating surgery, but some of the stories on here are scary!

I am a professional musician and guitarist, and have experienced pain in my right forearm for over two years. It has made playing much more difficult, but not impossible. After 2 years of wrong diagnosis, (everyone assumed it was just tendonitis - and told me to quit playing for 6 months. which is impossible for a guy who plays 6 hours a day, and who's family relies on this as his income) a new doc finally found a cervical rib on that side, and diagnosed me with TOS. I have a nerve entrapment on that side and I will need to have the cervical rib and the first rib removed as well.

My life has been pure hell for the last 2 years, including trying different techniques playing to splints, medication, etc. The pain is certainly nerve related, as I had a negative EMG. My last 17 years have been dedicated to pursuing this music career (as a music teacher, performer, session man, etc. no illusions of 'fame' or anything.) including over $100,000 on a music degree. I suppose I would rather deal with this pain the rest of my life than lose my ability to play if the surgery goes wrong.

The stories about recovery scare me because there is a possibility that I will wake up from surgery and be worse off than before. The doc himself said there is prob a 5% chance of nicking a certain nerve, or making the pain while playing worse or even losing my ability to play altogether.

The doc said more than likely I will be able to start playing again within a few weeks of surgery. But there seems to be a lot of people here that have residual pain long after the surgery - worse than the initial pain that the surgery was for!

I am hoping that in two months I can play pain free - even from the surgery - but I am not seeing a lot of hope for this. My doc is a cardiovascular & thoracic surgeon - not the type of surgeon y'all were discussing.

Any help to ease my head would be appreciated! I desperately need to be pain free and want to continue a career that I have spent so much time and effort on. I don't want to have the surgery if I can't be pain free or there are NEW pains to deal with.

Thanks!

Khicks - good luck. I completely relate and am worried like you. Personally the odds of successful surgery are enough to make me avoid it. If your doctor is saying 5% chance I'd hear that as more like 15% chance. Personally I have yet to read about someone who has had long term success going under the knife and I have read almost every site out there on TOS.

Do other readers of this group agree with 343v343 that there are no reported cases of long term success with TOS surgery?

I should specify, that the results I was referring to was with neurological thoracic outlet syndrome only. I know, people have had success with vascular and arterial. It seems, that people with just ntos symptoms only do not fare very well. I have thought long and hard if I would ever go under the knife, and my gut tells me that my luck… I would just be worse off than when I started. I am committed to trying everything I possibly can to either live with my symptoms or try to improve upon them with stretching and strengthening where I can. Whatever decision you make, you have to live with indefinitely.

I am not trying to scare you or dissuade... It's a tough one.

Thanks for the clarification. I had both ntos and atos symptoms. The ntos symptoms drastically declined for me after doing Egoscue postural exercises and putting more focus on good posture. I was also doing chiro at the same time, so that may have helped as well.

Circulation issues remain for me. Currently trying osteopathic manipulation. Just got started.

It seems, from research that if you have three extra cervical rib… That your prognosis is significantly better. Also, it seems that those who find relief from surgery are those who have vascular involvement. If you are improving your neurological symptoms with stretching and exercise… I think that is a good thing. If you want to have surgery to address the vascular issues, I think that is something to consider.

Hello khicks,
I placed a copy of your post in a thread of your own for hello's and replies -
http://neurotalk.psychcentral.com/sh...861#post816861

PubMed TOS surgery: long-term functional results
http://neurotalk.psychcentral.com/sh...ad.php?t=17275

Most good surgical outcomes don't need support, or seek out forums like this...


If I was at a point of having to consider surgery or not - the question for me would be -
"do I want to take a risk on surgery or not, after reading what might go wrong???"

Good point. Wish there were more documented cases of ntos success. The pubmed articles seem too optimistic.

Chroma-Regarding your ntos symptoms, how bad were they (i.e intermittent tingling, numbness, etc...) at their worst and what are they now? Sounds like you've made a lot of progress!