[WonderWhatItIs]

Please advise on a doctor sympathetic to looking at TOS. I am trying to discern if I have this syndrome and need a doc who is open to the possibility. THANKS

[Jomar]

I don't know if distance wise (Newberg, OR) this will work for you but here's the info anyway.


I had some very good help as well as a comprehensive evaluation by Bud Herigstad, PT - the owner of the PT place linked here- http://www.chehalempt.com/

another info page
[Chehalem Physical Therapy

Byron Herigstad PT, Stewart McComb MSPT, CPI, CSCS, Peter McLean DPT, Stephanie Schultz DPT, Maria Tang OT, CHT
Professional Services:

Physical Therapy, Occupational Therapy
*Direct Access Without Referral]
http://www.nwrehab.com/ClinicInfo.aspx?id=107

[WonderWhatItIs]

[QUOTE=Jo*mar;755642]I don't know if distance wise (Newberg, OR) this will work for you but here's the info anyway.


I had some very good help as well as a comprehensive evaluation by Bud Herigstad, PT - the owner of this place.
another info page

Byron Herigstad PT, Stewart McComb MSPT, CPI, CSCS, Peter McLean DPT, Stephanie Schultz DPT, Maria Tang OT, CHT
Professional Services:

Physical Therapy, Occupational Therapy


Thanks I'll check into this if I am not happy w/ the group of PT's I'll be seeing today!

Did they help you toward a diagnosis? Or were you already dx when you began seeing them?

[Jomar]

Didn't have a firm dx from a doctor, did have a dx from my chiro & another PT guy that did the eval for the physiatrist that I saw a few times.
Physiatrist didn't dx TOS he would only call it "chronic cervico/thoracic strain with arm pain"
But his PT that actually did the eval did feel it was TOS but I guess the Dr didn't want to change his written dx.
I was hoping for a firm dx on paper to take to my wc hearing. I'm doing OK as long as I pay attention.
My PCP dr would only call it chronic soft tissue damage.

When I went to see Bud, I made the appt for a full evaluation and asked if he thought it might be TOS due to my repeated RSI injuries in the short time frame.
I did fill out forms with previous injuries and symptoms etc so he had that info too.
He also studied ergonomics and is a ergo consultant for businesses I believe.

He did the checks to rule in/out c spine injuries/causes Traction/compression /angles etc - same as chiro did and the other PT at physiatrist place.

He did find that my top ribs were raised and stuck up in that position- that was causing more compression with collar bone and things in between the two.
He dropped the top ribs down and wow I could drive home with no arm problems.
he alos gave me the best passive posture /stretch ideas I have it posted on my profile album - just click my username and go to my profile to see them.

[WonderWhatItIs]

Originally Posted by Jo*mar

Didn't have a firm dx from a doctor, did have a dx from my chiro & another PT guy that did the eval for the physiatrist that I saw a few times.
Physiatrist didn't dx TOS he would only call it "chronic cervico/thoracic strain with arm pain"
But his PT that actually did the eval did feel it was TOS but I guess the Dr didn't want to change his written dx.
I was hoping for a firm dx on paper to take to my wc hearing. I'm doing OK as long as I pay attention.
My PCP dr would only call it chronic soft tissue damage.

When I went to see Bud, I made the appt for a full evaluation and asked if he thought it might be TOS due to my repeated RSI injuries in the short time frame.
I did fill out forms with previous injuries and symptoms etc so he had that info too.
He also studied ergonomics and is a ergo consultant for businesses I believe.

He did the checks to rule in/out c spine injuries/causes Traction/compression /angles etc - same as chiro did and the other PT at physiatrist place.

He did find that my top ribs were raised and stuck up in that position- that was causing more compression with collar bone and things in between the two.
He dropped the top ribs down and wow I could drive home with no arm problems.
he alos gave me the best passive posture /stretch ideas I have it posted on my profile album - just click my username and go to my profile to see them.

Oh, I didn't think physical therapists could diagnose! Or, at least I didn't think they could, formally. I'm thinking this because they aren't MD's or PhD's. Am I wrong?

Should I steer my reg dr toward examining my soft tissue near neck, etc? No one seems concerned enough to look.

Should I insist on an ultrasound of shoulders or neck?

[Jomar]

I should have clarified that it was not an "official" dx on paper by the PT guys or chiropractor, but it just clarified for me & my own knowledge that I was not out in left field in thinking that it might be TOS.

I suppose if I had more pain and more severe symptoms the MDs would have been more interested. Or if they thought they could rx meds for me or do some sort of surgery , but mine sx would calm down with good PT, chiro & my own home care program.


The physiatrist did rx a set of c spine & T spine MRI & xrays, basically to rule in or out any problems from those areas.
Nothing significant showed - minor osteophytes c 4- c6
No arthritis to speak of
He also did a NCV/EMG before that, when they were still focused on the RSI part of things (work comp). all normal on that too.

[WonderWhatItIs]

That was my mistake in misunderstanding you, sorry about that.
I had my PT visit/evaluation today- what a relief! This guy actually listened to me! To the whole picture!

He did some neurological tests on me first, since I told him I've been dealing w/ a neurologist, etc. He said, all neur tests look good on me, that he sees no reason to think my issues are neurological. Phew- I was very glad. Even my neurologist didn't say that! But why would she?

He talked a bit after the physical/evaluation about something called TOS. I was so glad he mentioned it! He said we can delve more into pinpointing whatever might be my nerve/soft tissue trouble over the next 6 visits.

But I'm not crazy in thinking i may have TOS yay... i just wanna know what I have so I can get an attack plan going.

[WildBioGrrl]

Originally Posted by WonderWhatItIs

That was my mistake in misunderstanding you, sorry about that.
I had my PT visit/evaluation today- what a relief! This guy actually listened to me! To the whole picture!

He did some neurological tests on me first, since I told him I've been dealing w/ a neurologist, etc. He said, all neur tests look good on me, that he sees no reason to think my issues are neurological. Phew- I was very glad. Even my neurologist didn't say that! But why would she?

He talked a bit after the physical/evaluation about something called TOS. I was so glad he mentioned it! He said we can delve more into pinpointing whatever might be my nerve/soft tissue trouble over the next 6 visits.

But I'm not crazy in thinking i may have TOS yay... i just wanna know what I have so I can get an attack plan going.

I just moved to Portland, and wondering who you ended up seeing, and how the therapy is going. I most definitely have TOS as well as c5-6 disk protrusion. I was getting great treatment in LA before I moved, and hoping to find great new docs and PTs here in Portland. Any insights for me? Thanks!

[jkl626]

Originally Posted by WildBioGrrl

I just moved to Portland, and wondering who you ended up seeing, and how the therapy is going. I most definitely have TOS as well as c5-6 disk protrusion. I was getting great treatment in LA before I moved, and hoping to find great new docs and PTs here in Portland. Any insights for me? Thanks!

Hi wild, could you share who your "great" treatments were with in L.A.?
Thanks,
jkl

[WildBioGrrl]

I was seeing Jennifer Wong, a PT at Hollywood Physical Therapy. She actually has mild TOS, so is very understanding of the disorder. We mostly did manual therapies. I just started with a chiro (no cracking!) in Portland who is doing a but more active mobilization of my ribs and shoulder, which Jennifer does not normally do much of.

My pain management doc was Dr. Roy Nini at Cedar Sinai Pain Center. My TOS is likely secondary (along with crazy rib dysfunction) to cervical disk issues, and Dr. Nini was doing a great job chipping away at the many layers of pain so we could figure out what was what.