I have a consult for neck injections this week and I just wanted to see what would be recommended for TOS. The doctor does trigger point, epidural, nerve block, and botox injections. Anyone have any recommendations? Where exactly does the doctor know where to inject and which type of injection to choose. My traps and scalenes are both tender and contribute to non stop waking up at night so I'm trying to relax them so that I can actually sleep one day in my life. If the doctor recommends botox, I might want to only have this reserved for Dr. Donahue in a few months since I don't want to interfere with his strategies.

Dr. Donahue doesn't actually do the botox himself. It is a radiologist that does, I think Donahue usually does the pec minor too.

I wouldn't recommend trigger points in the neck. Some shitty pain specialist did this to me, telling me they were doing the scalene and made me sooo much worse. She also made me get a psych eval when this didn't help.


QUOTE=cppoly;1080349]I have a consult for neck injections this week and I just wanted to see what would be recommended for TOS. The doctor does trigger point, epidural, nerve block, and botox injections. Anyone have any recommendations? Where exactly does the doctor know where to inject and which type of injection to choose. My traps and scalenes are both tender and contribute to non stop waking up at night so I'm trying to relax them so that I can actually sleep one day in my life. If the doctor recommends botox, I might want to only have this reserved for Dr. Donahue in a few months since I don't want to interfere with his strategies.[/QUOTE]

Hi-its great that your Dr. does all of these. What does the Dr. recommend? I have had Scalene Block, TRP injections and Botox and now I am going to try an epidural, but that is because I also have a disc bulge pressing on a nerve in my neck.

My advice would be to try trigger points first. I have been doing them for a couple of years.They can help relax the muscles. Sometimes I will get a flare from the injections in my neck but if I go on ice it is better the next day. I have it done in my neck, traps, shoulders, pec, teres, wherever there is tightness or spasm.It only lasts a couple of weeks though. The Dr. should use ultrasound for them. Very important so it doesnt go in the wrong place. If it works then you might want to try botox because it is longer lasting. Botox didnt work for me-I actually had a bad reaction but everyone is different. If it does work it can last alot longer. I dont know much about nerve blocks-I had a scalene block done to diagnose TOS but it is very short lasting-just a few hours.

Thanks for the info. The doctor recommended trigger point injections in the traps and scalenes. He will use an anesthetic and a steroid combination. I'll look out for the ultrasound as a guide. Before injections he wanted me to try a neck patch for my neck called flector patch. If this doesn't work I'll just have to wait for my consult with Dr. Donahue in a few months.

I received trigger point injections into the L scalenes once at the UCLA East-West Medicine Center, and by the time I got to my car, my left arm was completely dead! The young Western doc administering the injections must have inadvertently hit the neurovascular bundle by mistake. This is why the type of imaging technique used is so important. My experience was several years ago; as I recall the doc only palpated the scalenes to locate his target. We TOSers so often have anatomical anomalies in this area, nerves running through muscles where they shouldn't, etc. The "deadness" only lasted a few hours, but it was scary at the time! Good luck with your procedures. I know you'll be careful.

Its definately worth a try, I wouldnt wait for Dr. donohue if you are in pain. you can tell him what youv'e tried already. I've heard he It sounds like this Dr. knows what he is talking about. Has he treatrd TOS before? I tried the flector patch-it made me very woozy.

I've had tons of trigger point injections in the traps. Getting to the anterior scalene is trickier. I would ask how they will know they are getting the right muscle. See illustration here: http://www.tosmri.com/studies/cs3.html