[Pinochet]

Hey all. I have had what I think is TOS for the last 3 years or so. Here is my medical history that makes me think that.

About 4 years ago I was visiting a chiropractor on a short vacation, he diagnosed me with forward head posture. He said that even though I wasn't having problems at the time, he felt I was on the brink of having problems. I didn't follow his advice, but I think he was right.

About a year after that I started noting my arms would go numb when I was asleep. It was the median and ulnar nerves. I also noticed that if I tried to start a work out regimin, if I worked my chest or shoulders I would get a strong, dull, chronic burning pain in between my shoulder blades (I never had this problem working out in college a few years before). I also sometimes get problems with chest pain, but it isn't angina. When I go to the gym I do cardio hard (pushing my heart rate to 90-95% of max) and that doesn't cause chest pain. The most common position that causes me chest pain is sitting on my chair at work.

So here is what I've done to try to fix my situation (excluding the medical care).

I got rid of my inner spring mattress and got a memory foam. Ever since I did that I no longer get medial nerve compression. Now I only get ulnar nerve compression. So far so good.

I (eventually, after looking for ages) found a good anterior scalene stretch. After doing that several times a day, the numbness at night completely stopped for a month. However it eventually came back. But when it did come back it now only occurs when my arm is both above my shoulder and bent (before doing the anterior scalene stretches, I would get numbness from various positions and couldn't pinpoint one that was worse than another). If my arm is below my shoulder it doesn't matter if I bend the elbow or not, if it is straight and above my shoulder I don't get numbness. But sadly I am a stomach sleeper and find myself waking up with my arms bent over my head all the time.

I am starting to do some pec minor stretches on myself. I have read a tight pec minor can contribute. But so far I am not noticing benefits.

I have also been doing a weight training regimin for the muscles that pull the shoulders back and open the thoracic outlet. Rows, reverse flys, good mornings, planks, etc. I'm working the erector spinae, rear delts, rhomboids, lats, abs, etc.

The combination of stretching my chest and neck muscles with exercising my back muscles (as well as changing the chair I sit in at home, I got one with better back support) has made the chest pain and burning in my upper back go down 80-90%. So I have mostly gotten rid of the median nerve compression, chest pain and burning pain in the upper back. My posture has improved too. But the ulnar nerve compression remains.

However like I said, at this point the only position that seems to cause it consistently is arm over the head with elbow bent (I get numbness both when awake and asleep doing this). Also sometimes if I put the bottom of my forearm on something hard I get it too, but most times not.

I really don't know what to do. I'm scared I'm permanently damaging the nerve and even if I get it fixed it won't heal. I still have good grip strength (130 pounds in each hand), but I worry what I'm doing to my body.

I've been to almost a dozen medical professionals. Orthopedists, chiropractors, physical therapists, massage therapists, ergonomic experts. None had good advice. The orthopedist thought it was cubital tunnel (I doubt it, if it were bending the arm at the elbow would cause numbness, as long as it is below my shoulder it doesn't. Even he couldn't explain that).

Does anyone know any good medical professionals in the Indianapolis area?

[olecyn]

Unfortunately, weight training is not recommended for those diagnosed with TOS. An educated TOS therapist would not allow this nor would Neuro's or surgeons. Body builders, weight trainers, butterfly swimmers are notorious for developing TOS due to over extension and build up of muscle constricting the BP. Sounds like your the typical AAA personality like most of us. Cut back on your work out and stop pushing yourself so hard. Im only saying this with love as we push and push. Been there done that.

Every professional says to sleep only on your back. Side sleepers constrict the BP also. Waking up with a clinched fist or jaw isn't fun. Not an easy task but it is doable with many pillows and lots of retraining the brain to relax and let go.

Check out The MELT METHOD and see if there are any instructors in your area. This has brought about fabulous softening and release of pain for me working on the connective tissue or fascia. You will love it.

The ulnar nerve prob will calm once you get the correct therapy and release the thickness/tightness then elongating the nerve sheaths/connective tissue/fascia. My ulnar nerve decompression has given me trouble for 14 yrs. It does calm down but you have to work at it. When it gets unbearable I have to have steroid inj which is not the best way but necessary at times. Constant nourishment of flossing the nerve hands-on is the best course of action.

When you interview physical therapist have a list of questions pertaining to TOS, RSI, fascia release, stretches. A therapist who has a degree in anatomy, a heller worker, or rolfer is optimum. A DO (doctor of osteopath) is educated in TOS where as med students never are. They also can be of help.

Originally Posted by Pinochet

Hey all. I have had what I think is TOS for the last 3 years or so. Here is my medical history that makes me think that.

About 4 years ago I was visiting a chiropractor on a short vacation, he diagnosed me with forward head posture. He said that even though I wasn't having problems at the time, he felt I was on the brink of having problems. I didn't follow his advice, but I think he was right.

About a year after that I started noting my arms would go numb when I was asleep. It was the median and ulnar nerves. I also noticed that if I tried to start a work out regimin, if I worked my chest or shoulders I would get a strong, dull, chronic burning pain in between my shoulder blades (I never had this problem working out in college a few years before). I also sometimes get problems with chest pain, but it isn't angina. When I go to the gym I do cardio hard (pushing my heart rate to 90-95% of max) and that doesn't cause chest pain. The most common position that causes me chest pain is sitting on my chair at work.

So here is what I've done to try to fix my situation (excluding the medical care).

I got rid of my inner spring mattress and got a memory foam. Ever since I did that I no longer get medial nerve compression. Now I only get ulnar nerve compression. So far so good.

I (eventually, after looking for ages) found a good anterior scalene stretch. After doing that several times a day, the numbness at night completely stopped for a month. However it eventually came back. But when it did come back it now only occurs when my arm is both above my shoulder and bent (before doing the anterior scalene stretches, I would get numbness from various positions and couldn't pinpoint one that was worse than another). If my arm is below my shoulder it doesn't matter if I bend the elbow or not, if it is straight and above my shoulder I don't get numbness. But sadly I am a stomach sleeper and find myself waking up with my arms bent over my head all the time.

I am starting to do some pec minor stretches on myself. I have read a tight pec minor can contribute. But so far I am not noticing benefits.

I have also been doing a weight training regimin for the muscles that pull the shoulders back and open the thoracic outlet. Rows, reverse flys, good mornings, planks, etc. I'm working the erector spinae, rear delts, rhomboids, lats, abs, etc.

The combination of stretching my chest and neck muscles with exercising my back muscles (as well as changing the chair I sit in at home, I got one with better back support) has made the chest pain and burning in my upper back go down 80-90%. So I have mostly gotten rid of the median nerve compression, chest pain and burning pain in the upper back. My posture has improved too. But the ulnar nerve compression remains.

However like I said, at this point the only position that seems to cause it consistently is arm over the head with elbow bent (I get numbness both when awake and asleep doing this). Also sometimes if I put the bottom of my forearm on something hard I get it too, but most times not.

I really don't know what to do. I'm scared I'm permanently damaging the nerve and even if I get it fixed it won't heal. I still have good grip strength (130 pounds in each hand), but I worry what I'm doing to my body.

I've been to almost a dozen medical professionals. Orthopedists, chiropractors, physical therapists, massage therapists, ergonomic experts. None had good advice. The orthopedist thought it was cubital tunnel (I doubt it, if it were bending the arm at the elbow would cause numbness, as long as it is below my shoulder it doesn't. Even he couldn't explain that).

Does anyone know any good medical professionals in the Indianapolis area?

[Pinochet]

The weight training has helped with some of the symptoms of TOS and forward head posture like the burning in the upper back. I am only exercising the muscles that pull the shoulders back and that assist in posture.

[OzKira]

I have just started MELT method at home and have found it helped my posture so much, increased blood flow to my back which I didnt know was a problem and gave me so much relief it was amazing. Here is a great list of Drs you might find one close to you http://surgerydept.wustl.edu/TOS_Consortium.aspx

[Jomar]

Originally Posted by Pinochet

The weight training has helped with some of the symptoms of TOS and forward head posture like the burning in the upper back. I am only exercising the muscles that pull the shoulders back and that assist in posture.

Some stretches to lengthen/release the front chest muscles should help.
The front chest muscles can become shortened overtime, that causes a "pulling forward" on the upper back muscles.
They need to release to work along with the back muscles strengthening and not fight it.

[20YrsTOS]

Originally Posted by Pinochet

Hey all. I have had what I think is TOS for the last 3 years or so. Here is my medical history that makes me think that.

About 4 years ago I was visiting a chiropractor on a short vacation, he diagnosed me with forward head posture. He said that even though I wasn't having problems at the time, he felt I was on the brink of having problems. I didn't follow his advice, but I think he was right.

About a year after that I started noting my arms would go numb when I was asleep. It was the median and ulnar nerves. I also noticed that if I tried to start a work out regimin, if I worked my chest or shoulders I would get a strong, dull, chronic burning pain in between my shoulder blades (I never had this problem working out in college a few years before). I also sometimes get problems with chest pain, but it isn't angina. When I go to the gym I do cardio hard (pushing my heart rate to 90-95% of max) and that doesn't cause chest pain. The most common position that causes me chest pain is sitting on my chair at work.

So here is what I've done to try to fix my situation (excluding the medical care).

I got rid of my inner spring mattress and got a memory foam. Ever since I did that I no longer get medial nerve compression. Now I only get ulnar nerve compression. So far so good.

I (eventually, after looking for ages) found a good anterior scalene stretch. After doing that several times a day, the numbness at night completely stopped for a month. However it eventually came back. But when it did come back it now only occurs when my arm is both above my shoulder and bent (before doing the anterior scalene stretches, I would get numbness from various positions and couldn't pinpoint one that was worse than another). If my arm is below my shoulder it doesn't matter if I bend the elbow or not, if it is straight and above my shoulder I don't get numbness. But sadly I am a stomach sleeper and find myself waking up with my arms bent over my head all the time.

I am starting to do some pec minor stretches on myself. I have read a tight pec minor can contribute. But so far I am not noticing benefits.

I have also been doing a weight training regimin for the muscles that pull the shoulders back and open the thoracic outlet. Rows, reverse flys, good mornings, planks, etc. I'm working the erector spinae, rear delts, rhomboids, lats, abs, etc.

The combination of stretching my chest and neck muscles with exercising my back muscles (as well as changing the chair I sit in at home, I got one with better back support) has made the chest pain and burning in my upper back go down 80-90%. So I have mostly gotten rid of the median nerve compression, chest pain and burning pain in the upper back. My posture has improved too. But the ulnar nerve compression remains.

However like I said, at this point the only position that seems to cause it consistently is arm over the head with elbow bent (I get numbness both when awake and asleep doing this). Also sometimes if I put the bottom of my forearm on something hard I get it too, but most times not.

I really don't know what to do. I'm scared I'm permanently damaging the nerve and even if I get it fixed it won't heal. I still have good grip strength (130 pounds in each hand), but I worry what I'm doing to my body.

I've been to almost a dozen medical professionals. Orthopedists, chiropractors, physical therapists, massage therapists, ergonomic experts. None had good advice. The orthopedist thought it was cubital tunnel (I doubt it, if it were bending the arm at the elbow would cause numbness, as long as it is below my shoulder it doesn't. Even he couldn't explain that).

Does anyone know any good medical professionals in the Indianapolis area?

I believe u have some form of TOS. Sounds like some of the symptoms I had. I tried some of the exercise u mentioned, but I had to stop. I think u need to slow down with the exercise, because it's going to make your situation worse. I lifted weights, and they told me I got TOS from lifting the weight over my head. I was building my shoulders. It's been 20yrs, and after two surgery, possibly a third, my situation has gotten worse. Find a doctor that knows about this, and go from there. But, don't give up or become frustrated. I've been there. If u need to get two or three opinions do it. It's better to get the best opinions, than settling for anybody. Be patient, but don't keep putting it off. GOD bless and keep us updated.

[Pinochet]

In the last 2 months, I've seen a decent PT and she verified that I have TOS. She did some tests that involve holding my arms in various positions and measuring my pulse to see if it was weaker in certain positions.

She told me most people will not need surgery for this. I"m hoping that conservative treatment (stretching, exercises, etc) can keep it from progressing. Right now I really don't have much pain, just numbness in my sleep. I get pain sometimes, but I've had it for 3 years and so far just numbness at night. Mostly when my arms are over my head (which I've heard is a sign the pec minor is causing a lot of problems).

I don't know. I"m worried. I get the impression TOS is something that most doctors don't know much about. Not only that, but even if you do get surgery the doc may not perform the right kind of surgery on the right body part (maybe you have compression at multiple points and he does surgery on the wrong part).

Anyway, I guess I'm worried. I'm hoping that conservative treatment either helps make this better, or at the least prevents it from getting worse. Like I was saying, doing exercises and stretches has mostly gotten rid of the upper back pain and the chest pain. But the numbness remains.

I'm going to try a massage therapist who does myofascial release. I hope that helps.

[heybro]

there is a list of pt here: inst. of physical art

do therapy for a good while
nerves are slow to heal
if any improvement keep going

surgery is last resort
there are a lot of bad docs out there
but some really good ones

you are more than half way there from just realizing this is tos

[Jomar]

Has PT mentioned rib mobilization, trigger points, posture work, learn to sleep with arms down in neutral position?

Also yoga corpse pose is usually good for a passive relaxation/stretch.

Explore our sticky threads for more info & various therapies.

[jkl626]

Originally Posted by Pinochet

In the last 2 months, I've seen a decent PT and she verified that I have TOS. She did some tests that involve holding my arms in various positions and measuring my pulse to see if it was weaker in certain positions.

She told me most people will not need surgery for this. I"m hoping that conservative treatment (stretching, exercises, etc) can keep it from progressing. Right now I really don't have much pain, just numbness in my sleep. I get pain sometimes, but I've had it for 3 years and so far just numbness at night. Mostly when my arms are over my head (which I've heard is a sign the pec minor is causing a lot of problems).

I don't know. I"m worried. I get the impression TOS is something that most doctors don't know much about. Not only that, but even if you do get surgery the doc may not perform the right kind of surgery on the right body part (maybe you have compression at multiple points and he does surgery on the wrong part).

Anyway, I guess I'm worried. I'm hoping that conservative treatment either helps make this better, or at the least prevents it from getting worse. Like I was saying, doing exercises and stretches has mostly gotten rid of the upper back pain and the chest pain. But the numbness remains.

I'm going to try a massage therapist who does myofascial release. I hope that helps.

Conservative treatment with the right pt and 2.5 years! of resting it-not working at the job that caused it and Trigger Pt. injections helped me. Botox did not but everyone is different.I Still have pain/numbness sometimes but much better.Neurontin has helped with the nerve pain. Flexeril at night helps with muscle pain.

it is important to try to get properly diagnosed although it sounds like you do have it based on the symptomes you are describing. A TOS surgeon or neurologist can help you diagnose it.It sounds like you have a good PT but try this list that Heybro mentioned if you need another one
http://www.instituteofphysicalart.com/ipa/referral/list
Where are you located?
Try this list:http://surgerydept.wustl.edu/TOS_Consortium.aspx for Doctors