Hi guys, Richard here, looking for some advice on where to go next With doctors, physio, and potentially surgeries.

Using dictation to write this, so sorry for any errors.

A bit about me; I have been suffering with what my pain specialist believes to be thoracic outlet syndrome for two years now, and haven't worked for a year.

Symptoms started as a bit of pain in my right shoulder after a days work, or waking up with a bit of pain. This gradually got worse To now where my neck, right shoulder, right arm, right hand, and wrist, Burn, tingle and hurt constantly.

My job is on a Minesite, I spent a lot of time at a desk, and driving off-road. Later on, desk work became unbelievably painful.

I have had MRIs, x-rays, CT scans, nerve conduction studies, of my neck, chest, and shoulder. None of these scans showed any abnormalities, other than some bursitis in my right shoulder. The TOS diagnosis took a year and a half!

A shoulder anthroscopy removed the bursitis, But didn't do anything for the pain. Later injections into my neck facet joints did help the pain- C6-7 injection turned off the pain between my shoulder blades.

The pain specialist wants to inject my scalene muscles next with Botox. If that doesn't work then I guess surgery- since they don't know what is exactly wrong it would just be a general poke about.

at the moment I have been prescribed lyrica, and a anti-depressant nerve agent called Allegron- both these helped initially but now don't seem to do much. On top of this I have the opioid pain killers, tramadol, and muscle relaxant's. I only take this from time to time when it's bad.

Day to day I take a pilates class in the morning , Recommended by physio-I find the gentle stretching helpful, but some exercises aggravate it. After that I take a spa/sauna. This really helps to relax the muscles. After that I take a rest, then take a run or walk, then do some more stretching, and back to the sauna in the evening. I find keeping moving helps. If I have an evening or afternoon sat on the sofa watching TV it really aggravates my neck and shoulder.

The questions I have for the Forum are;
1 which specialist should I be seeing? Is it a vascular surgeon? Neurologist? Neurosurgeon? or should I stick with my pain specialist? I don't feel my TOS has been throughly diagnosed, and my hand and forearm pain properly investigated.

2 my neck seems to be the primary cause of pain now. It's weird since it started as a shoulder problem. Has anyone else had this migration of pain?

3 which doctors are best to see for report writing? I am about to go to war with an insurance company for liability. I think my pain specialist would do a good report. But it's not really her area of expertise. Would a neurologist be best? The independent medical investigator I saw hardly gave credence to my work duties causing the TOS-he was a consultant occupational physician

If you have read this all this, thank you. I feel a better for having got this off my chest, and shared amongst people who can relate.