hello all... this is my first enrty. I was diagnosed today with TOS.. I am a RN and had a bad fall at work july 20, 2007. After a gammot of tests for symptoms such as..chronis neck arm and shoulder pain, weakness of right arm, numbness of arm and normal findings, I was sent to a nuerologist who diagnosed TOS. This is a work related injury and I'm currently on modified duty. I have chronic pain that is unbearable the majority of the time. I am just looking for a little hope, that this problem will subside and I will be able to go back to my job as a critical care nurse. The nuerologist who diagnosed me today told me I'd get better at some point cont with PT and shuffled me out the door. I am currently recieving PT 2 days a week, but I have not seen any monumental changes. If anyone out there has any advice it would be much appreciated. I need hope....

Work with the PT but don't let them make you do any strengthening or anything that causes you more pain. TOS is a long long road. It takes time for even the smallest of improvements. Good luck and hang in there.
You'll find there are some wonderful people here to support you, to encourage and educate you.
Sandy

Thank you for writing back. I'm curious if there are any other treatment modalities that have helped anyone with TOS???? I know this may be a long road, but are we talking months or years?? When do I know it is ok to go back to work as an RN?? Do I just deal with the pain at some point and go back to work or will this make everything worse??

Sandy made a good point about PT.... don't be shy to let them know that X makes Y worse, etc. Regarding how long before you recover; I think that is very dependent on your particular case and what type of work you do (RN, right?) There are a couple of other nurses around here nearly all the time, fyi.
My humble opinon on the Q about just dealing with the pain is...... I just dealt with the pain from a shoulder injury for 6 yrs, and I'm convinced thats part of the reason that I'm here today. Yes, to some extent, we just have to deal with the pain- manage it, so it doesn't manage you, etc. If you haven't yet, I would recommend trying to see a Pain Management specialist.

Take care, and welcome!
-dabbo

Some of us have had some relief with chiropractic, myofascial massages, posture work & types of bodywork, heating pad, Electric stimulation, low level laser...
myofascial massage-
http://www.holisticjunction.com/cate...l-release.html

time -
I was injured {RSI/TOS} in spring of 03, worked modified duty till October, then was off work. I was pretty messed up for awhile {hands, arms, shoulder, upper back & neck pains}- then finally had some good improvements with 2 sets of decent PT and the time off from work.

In spring of 04 they sent me back to full work - I agreed to try it because I was feeling pretty good - I didn't last very long though, only 2.5 months total, I was hurting after only a week and it just got worse and worse.

If I hadn't tried going back to work I probably would have been OK after a year. But still with a chronic tendency for RSI if I did certain things & with the pulse stopping with the arm in certain positions.

Working in 04 gave me the set back that added another couple of months to the injury, and then I was feeling pretty good again - so I helped make a concrete floor for our shop, a weeks worth of heavy lifting, shoveling etc- severely injured myself with that.
Major muscle spasms that felt like my head, neck and chest were "locked up" . not fun at all.

While I was still having these spasms I came across a very good chiropractor who was a great help with the spasms and misalignments.
I was still not able to get my neck to completely relax, it would tighten up very easily.
So in 2/05 found an advanced PT to do a full evaluation since my Drs hadn't really put a name to my condition yet. He just decided to try to mobilize my top ribs and they dropped which relieved so many lingering sx! After that I was well on my way to many normal activities.
Both the DC & that PT did more for me as far as pain relief and healing than any of the drs I had seen.
I still go to the chiro each month- he uses all of the modalities I listed above as well as any adjustments , even does the C1/C2 adjust.

So for me it was bad for 2.5-3 yrs & I still get odd twinges, sx or triggerpoints if I don't keep on top of my stretches and posture stuff.

But everyone seems to get a different version of TOS and /or other things along with it- so it's hard to compare specifics sometimes.

My suggestion is to aim for complete pain reduction and then take more time still before even trying to go back to work.

Questions-
What are they doing for you at the PT place?
what kind of treatments ?
Bad PT can mess you up as much as working- if anything is seeming to make you worse please don't keep doing it - stop and firmly tell them that it is hurting more. {usually weights, stretchy bands are used way too soon- some can't tolerate them at all}

well since I wrote a novel LOL I better take a break.

I had great luck with hellerwork and myfascial release massage. I also see my chiropractor 1/week, i consider her a neccessary part of gettign by day to day. I have a PT who is a feldenkrais instructor, he is very good at "gently coaxing" movement by using very small motions well within your range of capability. I ahve another PT who is very experience with TOS and also has done specialized training with osteopathic doctors to develop a very "eclectic" (her words) approach. She is consitently helping me get aligned vrom the feet up, helping my ribs get more mobile, and targeting specific areas that i need to strengthen (like my butt!!!) and has really helped me find a few exercises that I can do despite my limitations.

In the end, Surgery and good surgical follow up was required to make the valiant efforts of my PT's work for me. I have also added some different medicines, after being only on narcotic for pain relief leading up to surgery. The muscle relaxer has helped, and even more, an anti-depressant had somehow relieved a very significant part of my pain.

I would suggest, too, that you get yourself screened for other possible complications- rheumatological conditions, endocinologic conditions- thyroid problems are common among us in this group- I waitied until more than a year after my original injury to get screened for it only to find my thyroid was really really out of whack. I now know that when it is out of whack i feel like someone is squeezing my back like a vice (thyroid issues are commonly known to aggravate RSI's and muscle spasms). Getting it treated has been a big help to muscle spasms, my mood and my energy level!!!

Like you, i was injured all at once- doing yoga. But that does not mean that repetetive strain does not contribute to furthering your injury. I worked through the pain for several months before stopping to go for surgery. Now that I am beginning to feel better, it is amazing to me how bad i was feeling. You forget what it is like to feel normal when you are faced with pain day after day after day.

My neurologist did botox injections to relieve muscle tightness, you might look into that. Other's do trigger point injections.

I second the idea to get your pain managed. It is critical to relieving muscle spasms- pain = clenching and protecting = loss of range of motion and muscle mass =more pain and weakness You have to find a delicate balance between keeping the strength you have and remiving activities which are hurting you- this is your best road to success. If you are confident in your PT, give it a few months to see if you feel like you are making progress. Even if you are, if after 6 months you don't feel better, you might really consider surgery. It sounds horrible, but it wasn't really all that bad, at least for me. If you are using a qualified TOS surgeon, it should be OK, and might be neccessary to help your recovery.

I also seem to be writing a book....I wish you every success. Early Dx and good treatment are key, which you've got. Many go for years with people not knowing what condition they have or how to help them.

Johanna