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


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Old 07-01-2007, 08:19 PM #1
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Default Question about arm pain

Hello,

When this all started >5 yrs ago, it started with quite a few symptoms but what is left is a deep ache in both forearms. It was there then, was covered up by the RSD pain and now the pump has taken care of the burning, I have the deep forearm pain again. If I press on it, the pain skyrockets

Does anyone think this could be a symptom of my initial diagnosis of TOS ??

Thanks in advance for your thoughts.
Hope
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Old 07-01-2007, 09:05 PM #2
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Question C8

The forearm is a path from the tos compression it follows the path all the way down as you can see in there dermatones,
Is this the pain area?
Di

Just a added thought, that does not eman it is your problem. If you relate it to the surgeon he many have some thoughts. It could be too, the surgery caused an irratation and it is going to calm down. For nerve pain, if that is what it is try Advils, I take three or four to help the pain.



Myotomes & Dermatomes

Spinal nerves have motor fibers and sensory fibers. The motor fibers innervate certain muscles, while the sensory fibers innervate certain areas of skin. A skin area innervated by the sensory fibers of a single nerve root is known as a dermatome. A group of muscles primarily innervated by the motor fibers of a single nerve root is known as a myotome. Although slight variations do exist, dermatome and myotome patterns of distribution are relatively consistent from person to person.

Myotomes

Myotomes - Relationship between the spinal nerve & muscle
Dermatomes - Relationship between the spinal nerve & skin.
Each muscle in the body is supplied by a particular level or segment of the spinal cord and by its corresponding spinal nerve. The muscle, and its nerve make up a myotome. This is approximately the same for every person and are as follows:

C3,4 and 5 supply the diaphragm (the large muscle between the chest and the belly that we use to breath).

C5 also supplies the shoulder muscles and the muscle that we use to bend our elbow .

C6 is for bending the wrist back.

C7 is for straightening the elbow.

C8 bends the fingers.

T1 spreads the fingers.

T1 –T12 supplies the chest wall & abdominal muscles.

L2 bends the hip.

L3 straightens the knee.

L4 pulls the foot up.

L5 wiggles the toes.

S1 pulls the foot down.

S3,4 and 5 supply the bladder. bowel and sex organs and the **** and other pelvic muscles.

Dermatomes

Dermatome is a Greek word which literally means "skin cutting". A dermatome is an area of the skin supplied by nerve fibers originating from a single dorsal nerve root. The dermatomes are named according to the spinal nerve which supplies them. The dermatomes form into bands around the trunk but in the limbs their organisation is more complex as a result of the dermatomes being "pulled out" as the limb buds form and develop into the limbs during embryological development.

In diagrams or maps, the boundaries of dermatomes are usually sharply defined. However, in life there is considerable overlap of innervation between adjacent dermatomes. Thus, if there is a loss of afferent nerve function by one spinal nerve sensation from the region of skin which it supplies is not usually completely lost as overlap from adjacent spinal nerves occurs: however, there will be a reduction in sensitivity.


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Last edited by DiMarie; 07-02-2007 at 03:37 PM. Reason: To add a thought
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Old 07-02-2007, 06:34 PM #3
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Arrow Doctor says

Thanks much Di.

The forearm muscle pain is from TOS.

Also, when I get an increase in pump medications, I have to hold this square over the pump and he has a hand held computer to up the dose.
I hold it there about 1-2 minutes at most and my arm muscles ache and I can't hold it any more. He said that was the TOS also.

I'm not sure if the pump is meant to help TOS but I'll try find out next visit.
Something tells me no one has ever gotten a pump for TOS alone. They have gotten a stim for TOS though.

's HOPE
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Old 07-02-2007, 07:51 PM #4
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Hope, many have had pumps for TOS, It is good because they can add all meds, baclophen for a muscle spasm, the morphine and or any other pain med, something for inflamation...everything goes in it

De wass going to get one. It was good as the meds would go in the spinal cord and not in her bad stomach or aggrivate the liver. The methadone they tried had her in liver failure, the psych emds and seroqual had her diabetic.

I had such hope for the pump,
it could have literally saved her.
Be well, I hope they can figure something else out to hold device or someone else to hold it for you.
Di
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Old 07-02-2007, 10:11 PM #5
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Di, I was aware of the Baclaphen along with the Dilaudid or Morphine... however I was unaware that they were able to mix any other medication through that ! Like I said that was ashame, she did not get it, I am sure the releif gained would have been priceless just based on my trial... he was nice as could be to me, though like I said sure like most surgueons can become crankey real easy!!! As always Diane you are a plethora of info !!!
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Old 07-03-2007, 12:11 AM #6
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HI hope, I still have terrible forearm pain. One doc said it was from tos, another said my tendon is trapped and needs to be released. I actually had the tendon release surgery booked when i finally got the call for my tos surgery( 2 year wait list) so had to cancel the 1st surgery. I was hoping the tos suregery would atke care of my arm too, so I wouldnt need another suregry,but im having alot of flare ups with it . After having so many complications after my tos surgery, I won't be giving in and having any surgery for a long time to come. 1 thing you can try is a tendonitis band worn just below the elbow. It really helped me to be able to continue to use my arms. ((((hugs)))) cindy
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Old 07-04-2007, 05:36 PM #7
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Red face Mixed up brain

WHAT was I thinking?
Of course people have pumps for TOS. I belong to a pump forum and am aware of all the meds in pumps, like dilaudid, clonidine, snail venom, baclofen, fetanyl, bupivicaine, etc. and diagnoses pumps are used for.

Where was my mind when I wrote that? I don't even remember writing it !
I read somewhere the only drugs that are FDA approved are Morphine and clonidine - not that doctors follow that FDA ruling. Someone has done clinical trials a few years back with ketamine, but None of the people from the pump forum I belong to ( > 550 ppl) use ketamine. Some just use baclofen for severe spasms but no need for narcotics. So it has a wide variety of uses.

I'm sorry Di, I know it hurts, but I sincerely believe the pump may have saved De's life too. I hated taking all the meds.
Di, you know Frogga on the RSD forum has been told she is too young for it. I know a mom who has a son that got the baclofen pump about 7 yrs old, he is 11 now.
I will never know if my forearm and elbow pain are from nerve compression because I've had 3 or 4 docs say I could never tolerate an EMG.
I can now straighten my arm, open and close my hands, (bend the elbow), lift a plate of food, but most task like brushing my teeth or bathing has to be done with rests periods because of muscle fatigue. I switch arms back and forth holding the thing that increases my pump dosages. If I drop it the doc picks it up and starts over.
All the improvements I have been blessed with are too much to bore you with here. It is a long list of goodies.
I wonder if I should be posting at all if I write things I don't remember & are wrong ?? I try to do the best I can.
HUGS & HAPPY 4th of July, hope
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Old 07-04-2007, 08:00 PM #8
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Hello Hope; So glad to hear of the improvements. Just sat down to read your thread. You are so funny. I find my memory is slipping and I have no pump. LOL. Just glad to see your post. Di your maps are really great, Take care all.
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Old 01-07-2010, 10:19 PM #9
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Quote:
Originally Posted by DiMarie View Post
The forearm is a path from the tos compression it follows the path all the way down as you can see in there dermatones,
Is this the pain area?
Di

Just a added thought, that does not eman it is your problem. If you relate it to the surgeon he many have some thoughts. It could be too, the surgery caused an irratation and it is going to calm down. For nerve pain, if that is what it is try Advils, I take three or four to help the pain.



Myotomes & Dermatomes

Spinal nerves have motor fibers and sensory fibers. The motor fibers innervate certain muscles, while the sensory fibers innervate certain areas of skin. A skin area innervated by the sensory fibers of a single nerve root is known as a dermatome. A group of muscles primarily innervated by the motor fibers of a single nerve root is known as a myotome. Although slight variations do exist, dermatome and myotome patterns of distribution are relatively consistent from person to person.

Myotomes

Myotomes - Relationship between the spinal nerve & muscle
Dermatomes - Relationship between the spinal nerve & skin.
Each muscle in the body is supplied by a particular level or segment of the spinal cord and by its corresponding spinal nerve. The muscle, and its nerve make up a myotome. This is approximately the same for every person and are as follows:

C3,4 and 5 supply the diaphragm (the large muscle between the chest and the belly that we use to breath).

C5 also supplies the shoulder muscles and the muscle that we use to bend our elbow .

C6 is for bending the wrist back.

C7 is for straightening the elbow.

C8 bends the fingers.

T1 spreads the fingers.

T1 –T12 supplies the chest wall & abdominal muscles.

L2 bends the hip.

L3 straightens the knee.

L4 pulls the foot up.

L5 wiggles the toes.

S1 pulls the foot down.

S3,4 and 5 supply the bladder. bowel and sex organs and the **** and other pelvic muscles.

Dermatomes

Dermatome is a Greek word which literally means "skin cutting". A dermatome is an area of the skin supplied by nerve fibers originating from a single dorsal nerve root. The dermatomes are named according to the spinal nerve which supplies them. The dermatomes form into bands around the trunk but in the limbs their organisation is more complex as a result of the dermatomes being "pulled out" as the limb buds form and develop into the limbs during embryological development.

In diagrams or maps, the boundaries of dermatomes are usually sharply defined. However, in life there is considerable overlap of innervation between adjacent dermatomes. Thus, if there is a loss of afferent nerve function by one spinal nerve sensation from the region of skin which it supplies is not usually completely lost as overlap from adjacent spinal nerves occurs: however, there will be a reduction in sensitivity.



This is the dermatomes chart I need, but I can't get it to copy.

DiMarie, is there any way you can send this to me, or Jo, as an email that I can save in Word? This is so helpful!!!
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Old 01-07-2010, 11:45 PM #10
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A right click on the image should give you options -
like "Save Image As" that's what I use most times.

Have to be sure to save it where you can find it like My Documents /My Pictures -
a little screen should pop open asking where to save it.

Once you save it in pictures or documents on your computer then open Word and open or import the picture
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