Hi fellow TOS sufferers. I was diagnosed 9 months ago after about 1 year of pain. Am in constant pain, unrelieved by advil, aleve or flexeril. Have tried 2 different physical therapists for months. Just visited orthopedist - xray found extra cervical rib on affected side. Was referred to vascular doc (Dr. Mark Stewart) and will see him on 3/29.

Lots of questions - Is there anything between PT and surgery? Are there any recommended TOS docs in Austin, TX? Should I try a chiropractor? Does working at a computer all day make this worse? Are there good career changes if I need to make one - teaching perhaps?

If any of you are in central Texas, please provide recommendations of TOS treatments that have worked for you. Thanks and bless you all!

Hi jd,
some answers to your questions-

Is there anything between PT and surgery?
Well possibly - long term {lifetime} Bodywork, Posture, ergonomics, learning how to stay away from things that cause flares/pain.

Some cervie ribs are small nubs and some are thick and a full set.
Did you have some sort of neck pain all your life or is it all new from the TOS?

Should I try a chiropractor?
I've had good help from a very good one- but I don't have the extra c ribs.
A full evaluation -with your xrays- by a very good chiro wouldn't hurt- but I wouldn't let them treat you until you are sure you have found a good one.

Does working at a computer all day make this worse?
YES-
Much of the cause is related to the static upperbody postures and fatigue of holding the arms forward and also the head forward. Then the shoulders hunch or roll forward and the c spine curve changes too, all of this causes decreased blood flow, sticky fascia, and compressions.

Are there good career changes if I need to make one - teaching perhaps?
If you are able to - anything that that allows freedom of movement and freedom to adjust to your needs body/use wise.
low stress, no quotas, no continuous heavy or desk work

Hi JD, welcome to the forum! I'm sorry that you're suffering from such relentless TOS pain - I hope you'll find answers, help, and comfort here.

Guess what - I live in Austin, too. I have bilateral neurogenic TOS (without the cervical ribs) developed from repetitive stress of computer/engineering work, and have been to what seems like every doc and PT in Austin over the past 4-5 years searching for relief. (Though amazingly never saw Dr. Stewart, the vascular doc you saw yesterday - how did that go, was it helpful?) Not having cervical ribs, and having mostly neurological involvement with no vascular symptoms, the vascular doc I saw years ago couldn't help me but you may hopefully have better luck. What symptoms do you have? Sounds only one side is affected right now?

I tried just about everything for the first two years - doctor after doctor, chiropractor, three different types of physical therapy, Feldenkrais - for me, nothing helped. I ended up flying to Denver to see Dr. Sanders and eventually had surgery on both sides with him. The surgery help the numbness but not the pain. Post surgery it's been a continual journey searching for pain relief or any thing that will help - I think I've tried as many docs and treatments after surgery as before! I did find a neurologist I liked and saw for over a year - he at least believed in TOS and was helpful in trying different medications that might work. However, I recently realized I needed better pain control then my neuro could offer, and I started seeing a Pain Management Doc instead. So far I'm really happy with him - Dr. Wesley Foreman at the Pain Evaluation and Treatment Center at 360 and Lakewood.

The only other thing that helps me personally is trigger point massage. I just found a new massage therapist at Massage Envy I think I like - he's TOS aware and has a clinical background. Unfortunately insurance doesn't cover massage so the cost can add up, but for me it's worth it. As for chiropractors, I tried one a long time ago and it didn't help me but others swear by them. As Jo says, your extra ribs may complicate things so not sure if it's a good idea for you are not, but two chiropractors have come highly recommended to me (I've never seen either of them, though) - let me know if you'd like their names as an option.

Ditto Jo's excellent responses to your other questions, especially the part about avoiding activities that trigger your pain. That's the hardest one! For me, that meant giving up my career and severely limiting many my favorite hobbies. I think many of us TOSers consider teaching as a potential career; however, I think even teaching could have many aspects that are not TOS-friendly. For instance, if it requires a moderate amount of writing, paperwork, using computer to prepare materials, even driving to class - these would be just too much for many of us, especially on the repetitive basis. But that's not to say it's impossible - in fact I myself hope to teach some sort of wine classes part time! I think the key is to be honest about your symptoms and limitations and the requirements of any alternate career. Then again you have an advantage - if you should ever choose to go the surgery route, the success rate for patients with cervical ribs is way higher than for others like me - so, there is the chance that you may someday find relief and all of this will be irrelevant to you!

Please let me know how you are doing and if you have any other questions, especially about care in Austin - I'd be overjoyed if I could help in any way. Hope this rain is not making your pain worse!

Take care,
Nolina

How did your vist go?

J.

Hey JD, thanks for sharing your story. i pray u are feeling better. Your story is kind of like mines, but mines is worse. if you have a moment, please read my story. i've been dealing with TOS for 20yrs or so. So i know what you are going through. i've been to PT, chiropractors, etc. i've taken all kinds of meds and had 2 surgeries, possible a third one. First, i was told after my second surgery, that i should not do anymore repetitive work. i'm constant on a computer every day. Teaching might be a good career change, but you will still be doing repetitive work. if i have this third surgery, i will change my career. PT, chiropractors, etc., didn't work. Two surgeries didn't work. So my advice to you is to make sure you find the right doctor. According to your post, it seems you do have some form of TOS. i don't know how bad it is. Make sure you at least get a second or a third opinion before you decide if you are going to have surgery. Ask a lot of questions. There is a Dr. Pearl in Dallas that i've heard about, nothing in Austin. Keep us up to date with your situation.

Thanks

I will.. thank you

J.