Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 03-05-2014, 10:17 PM #1
Atl_Golfer Atl_Golfer is offline
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Join Date: Mar 2014
Location: Atlanta
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Atl_Golfer Atl_Golfer is offline
Junior Member
 
Join Date: Mar 2014
Location: Atlanta
Posts: 10
10 yr Member
Default TOS or Something Else? Need Guidance

Thanks in advance for thoughts based on my history and MRI results below!

ME:
- 49 Years Old
- Played Golf/Hockey/Soccer since age 11.... notable head to goalpost hit roughly 2006... felt neck pain for a while, but seemed ok at the time
- Spend a lot of time with hand on my PC mouse, bad posture staring at monitor

START OF SYMPTOMS- Roughly Jan 25 2014, woke up one day with numb index finger... played golf (actually played well!). When didn't get better (in fact started feeling more pain in shoulder, burning under arm, numb index finger), saw massage therapist (~2/10), chiropractor (~2/16), and then PT (~2/24) and wound up getting MRI last Sunday (3/2). Have tried Aleve and Meloxicam but neither seemed to do the trick really.

MRI FINDINGS:
The cervical spine demonstrates normal alignment.Vertebral bodies are normal in height. There is a normal marrow signal pattern. Intervertebral discs demonstrate varying degrees of decreased T2 signal in keeping with overall mild multilevel degenerative change.. Varying degrees of facet and uncinate arthropathy present. The cervical spinal cord is normal in signal intensity. The craniocervical junction is normal. The included intracranial structures are grossly normal. The paraspinal soft tissues are normal.

Evaluation of the individual levels demonstrates:

C2-3: No disc protrusion, neural foraminal or central spinal stenosis.

C3-4: Disc osteophyte complex, asymmetric to right, slightly effacing thecal
sac, no neural foraminal or central spinal stenosis.

C4-5: Disc osteophyte complex slightly effacing thecal sac, no neural foraminal or central spinal stenosis.

C5-6: Disc osteophyte complex asymmetric to left effacing thecal sac, no right and slight left neural foraminal narrowing, no central spinal stenosis.

C6-7: Disc osteophyte complex, asymmetric to right slightly effacing thecal sac, slight right and mild left neural foraminal narrowing, no central spinal stenosis.

==================================================
PT person gave me a good "Treat your own neck" (McKenzie) book that has many good stretches I've tried... but when I push down/ back on my chin, I feel the numb/burn in finger and under my arm so I backed off that. Moist heat followed by some stretches and then ice seemed to help a lot today, so that's my current mode.. do that a few times each day. Actually felt decent around 11 AM today, but now some more burning under arm again tonight.

================= CALL FROM DOCTOR TODAY ==============
"I looked at your MRI and I think there is a chance that you have TOS so I'd like to give you Gabapentin and do some more PT". I took my first gabepentin tonight.
=================================

Questions for you guys:
1) Based on MRI above, what do you think? TOS? I thought TOS symptom was numb in pinky as opposed to index finger.
2) What sort of PT should I pursue?
3) Is gabapentin a good choice for med? When will I know if it works
4) Could this likely be fixed (slowly) by fixing my desk posture, doing PT and etc. Problem is when I lean way back in my chair and reach out with my hand as if to reach a mouse, I feel the pain under arm and into index finger now!
5) Any other tips/ guidance?

Thanks in advance.

Mike
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Tags
foraminal stenosis, gabapentin, numbness, shoulder pain, thoracic outlet syndrome


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