Last night I started getting sharp, shooting pains on my TOS side neck and shoulder and up into my lower jaw. Woke up this morning and had a few episodes of the same pain. I have never felt this before. My main pain symptoms have been scalene muscle soreness and the burning, aching in my left arm. And my scalenes have not hurt since I had Botox a few months ago and Tramadol keeps my arm from aching. Has anyone else experienced sharp, shooting pain? I did go to PT yesterday and I stretched my scalene and had the TENS on the base of my neck and around my clavicle. I find it frustrating that I have to speculate if every pain/sensation I feel on my left side is TOS related.

Possibly delayed pain from the PT work?
Do they do any triggerpoint release work before stretching & TENS?

If there are TrPs those must be released before the muscles can be properly addressed.
TrP info sticky thread
http://neurotalk.psychcentral.com/thread125577.html

Sometime's i'll get this "zap" feeling in my scalene area. I always associated it with stiff muscles up top there. A nice PT massage really helped me out.