I'm scheduled to have these injections this coming Thursday at 9:30 AM. Figured I'd just post here and keep everyone posted on how it went and if there are any change in symptoms over the next two months or so.

This is via Dr. Donahue at Mass General.

Just scalene injections, no pec minor. Interestingly enough, when I asked "why no pec minor" the other day, the office manager read right from the report that I had a "palpable spasm in the anterior scalene." I don't even remember Dr. Donahue mentioning this.

Anyways, will check in later in the week. I was told that pain isn't really an issue and that I can drive myself home. I've had several CT-guided shots in my day in the shoulder region due to MRIs with contrast so this really shouldn't be a big deal.

The real question will be: Does my mild flare up symptoms of scapular pinching /burning disappear.

We'll see.

KY

I hope it goes well for you and eases your pain.

Hi there,

As you know, I had Botox injections a few months back. The only pain I experienced was when the lidocaine was injected, and there was discomfort for my pec minor injections due to the length of the needles.

I hope you find some relief with this intervention.

Take care,
Laura

Thanks.

My pain level is usually very low to non-existent, but I do get a flare up every now and then. The flare up usually comes right when I think my TOS symptoms are gone completely. TOS is keen on keeping me on my toes.

Because I'm sick of this yo-yo type symptom situation, I figured why not get the injections? Best case scenario, this gets me over the hump. Worst case, I have to continue to manage an annoying yet not yet debilitating situation.

Question: Was anyone limited post injections?

Just curious if I can drive/turn my head/exert myself or if it's just a bit sore in the area. I've had many MRIs with contrast and never felt like it was too much of a big deal.

KY

Botox injections complete.

It was a breeze. There's no reason for concern around the actual prodedure. Dr. spent 5 minutes explaining, 5 minutes preparing, and after numbing the skin, the injection was done in a matter of seconds.

I was told to "lay low" for a couple of days, but to be honest, I feel like nothing took place. Working same day not an issue.

It was interesting to note that it takes two weeks for the botox to make an impact (if it does at all). Also, Dr Donahue's office indicated that on average, relief is seen for 60 days (if at all), and that 70% of patients see relief.

To be honest, I'm on the fence for what I'd like to see. If there's complete relief, that may mean that I'm a candidate for surgery down the line if symptoms increase. If there's no relief, ok no surgery, but then the question is, what is the issue.

I'll keep everyone updated on how I feel in a couple weeks. In terms of my symptoms, my pain level is quite minimal -- usually a 0 to 1 on the pain meter most days while a flare up can ratchet things up to a 2 or 3. Not terrible, but an inconvenience for sure.

Be back in a couple weeks.

KY

Quick update on this front.

It's been a little more than two weeks since the injections. I was told that it takes two weeks to take effect.

Verdict:

I'm not sure.

I do feel like some scapular pinching/burning has disappeared. Same thing in the tricep. That said, these usually mild symptoms seemed to recede at the same time last week when a very stressful time at work passed. So, it's really hard to say if the botox injection did anything.

That said, the one thing that I noticed yesterday was that the presence of my "bruit" was completely gone. I used to notice that on say, every 3rd or 4th heart beat, I could feel the "turbulent blood flow" under my finger right where the subclavian artery runs. It was pretty consistent.

Now it's completely gone.

So it could be that the scalene muscle has been loosened enough that it's no longer strangeling the subclavian artery.

I'll have to keep monitoring this.

The true test will be the next stressful period at work.

KY

Update:

Had the injection on March 1 so it's been almost two months since the injection. Since I was told that it takes a couple weeks to take effect, I'm theoretically 1.5 months into a process that would run 2 months.

I'd say the results are somewhat of a mixed bag.

The good:

* The "bruit" that was present is gone. Previous to the injection, I'd guess that I could feel "turbulent blood flow" when I try to find my pulse in the thoracic outlet area. Now, can't feel it. I'd say this is a good sign. I'm curious if this comes back in a couple weeks when the botox injection should wear off. I'm monitoring this very closely. It's the only clear observation of change so far. If I start feeling the bruit again, that's going to tell me that yes, the scalene muscles may be a problem we have to deal with in the future.

The bad:

* Still get flare ups. Not too bad. Usually revolve around work stress and travel. Pain goes from 0 to maybe 3, but then within 24 hours of relaxation it's gone.
* Physical activity does not impact my condition at all. If anything, a workout helps. I've found that after a stressful work trip, a visit to the gym helps settle me down and get me back into a routine. Really strange. Wonder if the release of endorphins has something to do with this. This one finding has me questioning if I'm really in a true TOS situation since most everyone on this board has problems with any kind of strengthening.

Anyways, we'll see how we are in a couple weeks.

KY

DId your insurance cover the Botox or did you have to pay out of pocket?

Hi just saw your thread. I had botox injections a little over a month ago. I had a very bad reaction,excruciating pain in the first 2 weeks then I started feeling relief. The scalpular pain definately got better, then I had trigger pt injections in rhomboids,traps,levator and teres minor and all got better except I have pain in my Triceps,Traps and arm nerve pain still. i think it is already starting to wear off, so in my case about 30% releif for who knows how long? I think it was worth it for my level of pain beforehand but I dont think I would do it again.

Nospam...my insurance did cover it. Blue cross blue shield. I actually could do it again before December 31st if I wanted.

jkl...the only change I've seen is with my bruit. It's gone. But to be honest, maybe this has nothing to do with the injection. I've been stretching rigorously for months now and also working my posterior muscles all in an effort to keep the area loose, pull back my scaps, open my chest, and keep good posture. It could be that maybe this is all paying off.

That said, if come mid-May the bruit is back along with more frequent flare ups it may be easier to connect the dots.

KY