[bwsnhp]

Not sure when it really started, but we'll say beginning of this year, I started getting tingling in my right hand and arm, up to about mid-tricep. I suspected my shoulder as this seemed to be related to the position of my arm, and would go away by moving my arm around. Mainly while sitting at the computer, which I spend a lot of time doing, but also other things like standing with my hands in my pants pockets. After a few months, it started getting worse, so I went to see a chiropractor who suspected a rib issue and treated for that for maybe a month. At that point, he said since I hadn't shown any improvement, I should go see a md to make sure something else wasn't wrong. A day or two later, I realized I had been sleeping on my right side, but laying over some causing my shoulder to be sort of folded under me. I decided to try sleeping on my back to see if that helped before calling an md. No change for a couple weeks, then one Monday my arm was "off". It just seemed to be in a fog, like I could almost just barely reach something, but not quite. Setup an appt with md, who prescribed medrol dose pack (which was no help) and sent me to orthopedic. Ortho took about a dozen xrays of arm/shoulder/neck, says they all look ok and he suspected carpal tunnel, gave me a wrist brace to wear at night (which was no help) and sent me to neurologist for emg/ncs. The ncs showed mild carpal tunnel syndrome. Orthopedic wanted to give me a cortizone shot which I was hesitant about, so he gave me an rx for dicoflenac (which I havent filled yet) and a followup in a month. The physical tests he did - bending my wrist, tapping my palm, etc, did not cause my symptoms to appear. He also didn't sound very convincing when he said it was carpal tunnel. I've never had symptoms at night, but I sleep pretty hard.

I'm concerned that I may have minor carpal tunnel per the NCS which isn't bothering me, but also have something else going on - like TOS, which is the cause of my symptoms. My right shoulder is rounded, head forward posture, I have a cervical rib (not sure to what extent) and the muscles around my neck/shoulder/etc are very tight (extra stressful year). I've been a heavy computer user for 20+ years. From what I've been reading, this almost sounds like a recipe for TOS. 40yo male, 5'11" 185lb, no trauma - so I don't hit all of the causes.

Any links to info/tests that might help me sort this out?

From what I've read, if this is TOS, it sounds like the dicoflenac may help with symptoms (pain/etc) but isn't going to be a solution. Does that sound right?

Thanks

[Jomar]

Computer use for 20+ years + the extra cervical rib + forward head/shoulders - can very well be TOS. or even TOS like as in disputed TOS ( no clear cut dx -usually is a chronic RSI)
the CTS could be from the upper issues or called a double crush syndrome.
But if mild rest/time & good PT should resolve it.
Make sure pc/desk area is very ergonomic if still working.

Any particular fingers having more issues than the others or all equal affected?
Index/middle vs pinky & ring?

If you post your area or a large city nearby maybe someone will know of a TOS knowledgeable doc for you. Most MDs are not up on all the nuances of TOS or chronic RSI/posture etc..

But the extra C ribs could be a main player, but a good TOS doc will be able to help sort out if surgery is called for or not.
In the meantime look for upper body posture fixes ,on you tube etc & we have some posted here ( http://neurotalk.psychcentral.com/album.php?albumid=422 ).
Proper /expert PT ( not just anyone) & a very skilled chiropractor should be able to get you started off too.
Make sure they know about the cervical rbs ..

[bwsnhp]

Originally Posted by Jo*mar

Any particular fingers having more issues than the others or all equal affected?
Index/middle vs pinky & ring?

If you post your area or a large city nearby maybe someone will know of a TOS knowledgeable doc for you. Most MDs are not up on all the nuances of TOS or chronic RSI/posture etc..

Thanks for the info. My tingling is hard for me to pin down. It's definitely affecting my index and middle finger, probably my thumb, and the section of my hand leading to my thumb through middle finger. I feel like it's the back of my hand (radial nerve), but I can't be certain. I can't seem to isolate it anymore than "inside" my hand/fingers. I'm also starting to feel an ache in my shoulder area, but that could be unrelated.

I'm located near Newport News, VA.

[bwsnhp]

After a month of diclofenac produced no change, and I re-iterated that it felt like the cause originated from my shoulder/neck area, the doc sent me for an MRI of my cervical spine. I went in today for the followup and he said the MRI shows a bulging disc at c5-c6 compressing c6 nerve root on the affected side. This seems to be a pretty close match to my symptoms.

I appreciate the information I found here on TOS. Looks like I need to go find a new group for this diagnosis

Oh, and based on the info I found here, that appear to be at risk for TOS, will likely cause me to change some things. like try to get the posture fixed.

Thanks