My chiro does ultrasound at the beginning of every session- the whole area from base of skull to mid back, sides of neck, shoulder muscles and sometimes he does the IF stim {deep electronic stimulation}, or the low level laser {for specific sore spots}

you might ask if PT finds any trigger points while she is working on you or ask about sticky fascia

all these topics are in the stickys too.

have you ever been in a car accident, hit your head or shoulders hard, sports accident, falls - hitting your head or upper body?

that's one reason I see a chiro- many yrs ago {as a teenager}went off horse and landed on my head- was Ok for the most part minor concussion.
When i started researching about RSI and then finding info on TOS -
I also found out about how the c1/c2 can get out of alignment fairly easily and causes the body to get tilted out of symmetry.

nose got crooked, shoulders , hips rib cage= all slightly tilted
plus another car wreck -hit nose on steering wheel and cracked it so even more cooked now LOL

I'll have to remember to ask my PT all these things! I should write them down.

Actually, I have never had any injuries to speak of. No broken bones, no car accidents, nothing...

BUT my boyfriend and I do have a motorcycle that we ride A LOT and I can remember 2 specific times where we've gone over bumps and it's jostled/slammed me around so bad that it hurt! That was probably sometime in July/August and this all began in Sept. Not sure if it's at all related but who knows. I just know that C4, C5, C6 and C7 all have Mild Deg. Disc Disease and slight bulging discs at these levels.

Thanks a bunch!

I have some slight bulging discs inthe cervical region that contribute ot the TOS but not the cause.

How much time with the computer do you spend everyday?

Computer was my downfall.

6-8 hours...

and I honestly think it's my downfall as well. Doesn't help that I don't have very good posture either...

I'm trying to change that.

Ugh the posture will kill you. Forward head posture is what they call it.

I still catch myself doing it.

I got my TOS primarily I believe from computer overuse at work at a bad ergnomic work station. Also, I lifted, carried, moved heavy files and remember carrying like two foot stacks of them into the court from the parking lot and my whole arms / hands going numb from that dumb act.

Anyways, I have this post that I always post for newcomers, so here it is:

TOS is a diagnosis when ALL other testing does not show an obvious orthopedic or other reason for all of your symptoms. TOS is a diagnosis when you have ruled out all other problems, because if you do not do the foundational TOS to rule these out, then you might have missed an obvious tumor, etc., but it does not mean that TOS is merely what you call it when you are done with testing. Testing is extremely important. Normal results in all, can still conclude TOS, if the proper symptoms are present. There is no single, one-shot test for TOS. You can't usually "see" it.

I am not a doctor, and this description of tests is just "laymens' terms."

1. You should have ruled out any rheumatological or immunological conditions by seeing a rheumatologist and having these blood tests run. Sometimes they will run a brain MRI.

2. Neuro / ortho / vascular doctors do MRIs of the neck, brachial plexus, shoulder, hand, etc., looking for any obstruction or strucural abnormality. These MRIs can be run with fluid, and may or may not have your arms in differing positions. Mostly, these are for finding any arterial or vein blockages.

3. Xrays are also ordered of the spine, usually in the beginning, and a few TOSers will have additional cervical ribs, but many do not. "Extra cervical ribs" or "protruding cervical ribs", etc., are the terms to listen for.

4. Neuro docs do EMGs and nerve testing, including SSEPs, each one believing that only their way is the right way. Usually, it is not always going to show anything. You want to ask if they test up by the neck for the C-8, because if this is slow, the C-8, it tends to show TOS rather than cervical radiculopathy.

5. Doppler tests are like sonograms of the arm to see if there are any blockages of blood flow. You can have neurogenic TOS and still have vascular / circulation type symptoms, but these may not show up on this test. Blockages must be treated usually by surgeries, ASAP.

6. MRAs or MRIs with fluid involves cut-downs along the arm to track blood flow, as you sit or stand. In my case, my nerves were wrapped around my double veins, so we were unable to cut-down all the way up.

7. 3d MRAs (or is it MRIs? I always get this one wrong.) By Dr. Collins shows different angles of the brachial plexus at such a high resolution that doctor is able to "see" compressions, impingements, etc. However, most of us do not get this luxury. (I think the cost is $7,500 right now?)

8. Scalene block - if you feel relief for a brief period of time, this is positive for surgery.

9. Thyroid issues - many TOSers are hypothyroid. Some show up easily on a blood test. Others, are not shown on a blood test. Some are called "Hashimoto's thyroid" such as mine. Mine were based upon symptoms, rather than numbers on a blood test. They incuded: dry hair, or slow growing hair, depression with no real situation or depression that has gone on a long time, nails that don't grow or are brittle, dry or flakey skin, sleeping 10 or 12 hours or a whole weekend like I was and still tired, not being able to sleep at night, tired when forced to wake up, (once I started the thyroid, I slept from 11 AM to 7 AM without problem), slow bowels, like not moving for a week, (not really weight gain or weight loss, though, this wasn't about being fat, but about not good body metabolism.) So anyways, this is a subject for you and your doc.

If all of these tests come out basically normal, this leads to discussion of TOS as the culprit. It is especially hard to tell the difference between cervical ortho causes and TOS, and sometimes shoulder and TOS. But you must go through time-consuming testing to find out all of the results, because if you simply proceed with an ortho surgery, your TOS pain can go through the roof and you can have unexpected complications, so it's rather serious to proceed now with great caution, whereas the work comp ortho surgeons love to "cut and run!"

We have a ton of articles post on the upper left hand corner.

We also have listed some of our docs we have seen, on the upper left hand corner. In my opinion, most doctors who say they know TOS can NOT diagnose TOS, and I went through over 10 orthos / neuros / vascular surgeons who did not diagnose me, and it wasn't until I flew to Denver and saw Dr. Annest that I got a diagnosis, and then most of these docs said "oh, that's what I thought, too, but didn't want to be the one to make the diagnosis."

Pain control is another big fight.

Be very wary of chiropractors who say they can "cure" TOS. Do NOT do any physical therapy or treatment that hurts you, or tries to strengthen you. TOSers (for the most part) cannot do strengthening exercises, cuz that causes swelling, which is already a problem.

The best physical therapy that I know of is the "Edgelow" system, he is listed in our doctors list in Berkeley CA. Many P/Ts do his system. You can get it via mail, too.

Try to stop using the computer and at any cost, PLEASE get voice software. Dragon naturally speaking is what I use. Just the pose at the computer, called “the gargoyle” pose, can trigger neurogenic TOS symptoms to flare.

Try to figure out how you got TOS, if you do get diagnosed. Were you in an accident to the collar bone area? Or, were you doing a job that had a lot of repetitive hand / arm movements over an extended period of time? IF you can't say why you got TOS and you're working, presume it caused the TOS, because if you look at how you spend your time, this is where / what you probably do the most if you are working full-time, and make sure to get an attorney consult and proceed with a claim. Do not wait, no doctor will take care of this aspect for you. And do NOT take anyone’s advice on this, ONLY an experienced, good, work comp attorney and the consult should absolutely cost nothing – FREE. No matter what, please get to an attorney to know your rights, and also, to know what you are RESPONSIBLE for also! There are time-sensitive forms, etc. The onus is on you to pursue your work comp benefits, which, sometimes TOS is 100% disabling condition.

Tam brought up a great point about chiropractic care..... It helps some of us around here, and I know it has helped me in general. I went to one chiro who KNEW she could CURE me in like 2 weeks. I pretty much ran right out of there. My "new" chiro made no such promises, other than he would do his best to help me feel better; he is also very mindful of where to and where not to push, adjust, etc.

And, Shelley had a GREAT term to describe correct posture.... I just remembered it, and I sat up straight!!.

LOL Dabbo we just met Missa

Ok one of the chiros I saw told me the key to good posture is to LWMY (lead with my nipples)

Remember that throughout the the day and your posture will improve and hmmmm all the men notice too

Thanks Dabbo I had forgotten that!

I laughed out loud when I remembered that Shelley.....

Missa- I think that writing things down is a great idea. I try to bring notes to every doctors appt; i would even bring them to PT to discuss certain things or ask them about new or different techniques. I also have the tightness in the shoulder/neck area. I think some of that is my bad posture.

Best of luck with the PT!

I'm on the verge of tears right now.

I went to the Neuro, told him everything I've been experiencing, mentioned TOS and asked him what it was... he completely disregarded anything I said. If I remember correctly he said, "Well, all my tests are normal. There is no nerve impingement and the EMG/Nerve Conduction Test is completely normal. It's not a nerve problem. I think you just have a pulled/strained muscle and Physical Therapy will help with that. If it doesn't, I suggest you see a Pain Management Specialist. But there is nothing more I can do for you."

WTF?

I understand maybe a nerve isn't pinched in my neck... but maybe somewhere else? And as I've read, people with TOS tend to have normal EMG's. I am just so upset about he just wrote me off pretty much.

What am I supposed to do now? Just keep going to PT and hope it gets better?