[MelissaB.]

Hi. I was a member of the old forum, but have not posted in a couple of years. I've had arm and shoulder problems that were eventually diagnosed as TOS for about 10 years.
My Question: I have occasional hip pain which causes a limp on the same side as my TOS. Does anyone else have this and can it be a part of TOS, or is it unrelated?

Thanks!

[bettertoser]

Originally Posted by MelissaB.

Hi. I was a member of the old forum, but have not posted in a couple of years. I've had arm and shoulder problems that were eventually diagnosed as TOS for about 10 years.
My Question: I have occasional hip pain which causes a limp on the same side as my TOS. Does anyone else have this and can it be a part of TOS, or is it unrelated?

Thanks!

hip pain has nothing to do with TOS. It can be bursitis. Have it checked out by a doc. I have it too and it goes away or lessons with advil.

[Jomar]

If your body is out of alignment from whatever reason- be it falls, MVA, sport injury, even being born can cause it.

It can also be more noticeable after having TOS for awhile due to possible guarding or posture changes due to pain.
Sometimes the change is very slight and as we age we get stiffer and our body is less fluid so things are more noticeable.

After reading some chiro sites about the atlas/axis {C1/C2} I realized that I have been out of alignment for 30+ yrs or maybe from birth- but who knows for sure.
I am pretty sure my shoulders were level and even until after my shoulder/neck "strains"- which I think was a precursor to TOS.
I had already had bilateral RSI a year before the shoulder strains started.
And I got RSI again as soon as they returned me to full work after PT for the shoulders.
I tend to get more of a sacroiliac pain inside low back/hip area.

A few here do get sciatic pain also.

So your pain is in the actual hip joint area?
Front, back, side of hip or deep inside?
Either way if it is very bothersome I'd have it looked at- just to be sure it's not something else.

DiMarie has some diagrams/photos/sketches posted in the useful links-
Heres the whole thread - in the first post is some good chiro links too- that can explain it in more detail.
http://neurotalk.psychcentral.com/showthread.php?t=84

[DiMarie]

Melissa,
I could never say with certainty that it is not related to TOS as it can affect the posture, if upper body is tilted it off balances the lower.

I always show this post:
re-post TOS affecting low back and tilted shoulders

--------------------------------------------------------------------------------

Found this picture explaining how we can have a positional problem from TOS causing a low back problem


http://www.whiplash101.com/ribtos.htm
The ribs make up the floor of the thoracic outlet with the main nerves that go to the upper extremity (brachial plexus) sitting on top. When the ribs are shoved up, as in the diagram below, the result is irritation of the brachial plexus and numbness down that arm. In many patients, direct trauma to the ribs is not required. A one sided, cervical facet injury (indicated in red on the right) causes the neck to tilt away from this painful joint. The brain then rights the head to keep the eyes level, thus forcing one side of the ribs up (black arrow) and causing TOS on the opposite side (numbness indicated by yellow arrow).


Also Dr. Togut so often refers to the trapizus muscles across the shoulders are shaped like a triangle coming to a point down near the waist. With this dynamic and them being the coat hanger of the scapulas (wings) if the dynamic is off, it can cause some hip or low back pain.

But, I had right hip pain for a while now I am 52 and just decided after 5 years to get the xray as it is getting more painful. It is DJD, degenerative joint disease. Just like the disc in the spine can lose height and degernerate my hip joint is wearing out.

I had right knee surgery and my right leg is a bit shorter then the other so I have a limp, that brought on an accelerated rate the deeration. I also have it in the knee since the surgery. Even the outside edge of my foot is tender from my stride.

I would get and xray and try some muscle relaxers....Biofreeze and lidoderm patches help somewhat too. Other wise I get some trigger point and Epidural spine injection.
Dianne

[bettertoser]

Melissa,

A patient can relate anything they want to a condition they have or a disease they have, but that doesn't mean that's why they have it. If a patient starts talking about a toothache causing toe pain, well.....you can see how that may look to the doctor.

In order to have a reliable patient relationship with your doctor just go to see them, say you have hip pain and let them decide where and how it came along. Let them know when it started and how, if doing something makes it worse. That helps a lot in diagnosing a medical problem. Most of the time if it is something simple, an steroid injection helps, or an anti inflammatory type med helps along with some PT. If it is something like a slipped disc or any type of disc issues in the back that's more of a serious condition.

That can also cause a limp and pain in the hip area. Docs can see that on an X-ray and MRI.

But relating everything one has to something like TOS can cause a person to not look further at another possible cause of a pain or whatever when it has nothing to do with TOS.

Ask your doc, they are the ones that can let you know what it's from. We can't. Hope you find some answers, take it from me, hip pain is no fun but with the correct DX you can find relief.

[johannakat]

When my back gets totally cramped up, the first thing the PT always ends up doing is straightening my hips.

When your hips (or any other part of your core) are ou tof alignmnet, your body has to compensate by holding different muscles tight. THose with TOS often already have either muscles that are way too tight up top, or way too weak (from not being able to use them) to help us compensate for any misalingment.

Your body IS a whole system. When one nerve is stuck is can easily affect how much your other nerves can glide around. They are all supposed to be able to move freely. when you stretch your arm or your leg and feel pain, if moving your head can change the amount of pain in the stretch, many cliniicans and PT's attribute the pain to nerves being stuck...not tight muscles. I had read about the slump test on my own, and one day (i didn't talk to her about it) my PT did it during a session. She said it clearly showed that the nerve compression in my upper body was contributing to pain in my legs. She now has me doing nerve glides with my feet

So whoever can argue that they aren't related, it may not be TOS directly that causes my leg pain, however, it certainly is related. Any PT or doctor who treats TOS like all it affects is the neck and shoulder is not going to get you better, either. Your whole body has to be aligned to have good posture, and bad posture is what got most of us here...at least to some extent. That is certainly why Dr Sanders and others sends people to feldenkrais practitioners.

Try the slump test and decide for yourself if nerve compression is contributing to your hip pain....

best,
Johanna

*including the new link for slump test site*
http://www.spinalphysio.net/

[Jomar]

yikers!
Just doing that test myself- I could feel a real difference just from having my head up or bent down! It really pulled in the hamstring area, almost zingers, would be zingers if someone was putting pressure down on my head.
http://www.innerbody.com/image/musbov.html

that whole site is kind of fun- not fully detailed though
but good for quick overviews
http://www.innerbody.com/htm/body.html

[DiMarie]

Thanks Johanna for the great info, you have an attune PT for sure.

I saw this statement on the site your refer and how fitting...how many times have we had symptoms treate locally with blinders on instead of looking at the general picture.

TOS mimics many things, and other thing mimic TOS, nothing should be ruled out or in to a local area with thinking about what is contributing.
WHen I was told degerneative in th ehip the doc's stop thre, but my ortho said it is all related and all posture, where the stress effects and the heavy wear and tear.

With the slump I do a side half roll over to stretch, trying to loosen. But I have the advantage to use the hotub for loosening things up. I can do lots of range when the hot tub is there.
Dianne

This was from the site your refered.
The Moral to the Story?
With musculoskeletal disorders, the human body has a habit of making life miserable for us, as Clinicians, treating these conditions. What we need is a "tool box" filled with different tools, able to differentiate between a multitude of conditions. The Slump Test gives us an avenue by which to apply our clinical reasoning skills, to be able to differentiate between symptoms of local origin and those of symptoms arising from the nervous system. We all have to take our "blinkers" off and use a little lateral thinking to be able to see the big picture - our patients will be happier paying their money!

[johannakat]

Di- the other thing my PT says that I think really really applies to TOS is "the body will always cheat" meaning, if something hurts, or is stretched too far or cramped or whatever, we'll compensate with other muscles to do things in a way we weren't meant to. With me, she started with the extremities and worked inwards to the neck. She still goes back out to the extremities whe something is out of whack, and puts requests in fo rthe hellerworker when she finds something too tight to deal with easily.

of course, i am still going for surgery....but they have helped me immensely.

Hot tub= fantastic. THe people at my club sometimes look at me funny, but i do that slump test stretch all the time in the hot tub. It is so much easier there. I also usually visit the sauna or the tub before i work out just to get me a little more limber.

knowledge is power. learn as much as you can

Johanna

[tshadow]

My pain started on upper right, moved to neck, then upper left, then lower left leg. Now I've got total complete paralysys of arms to elbows, and left left, for about 4 hours a day, once a week, which then slowly fades out. It has occurred at the docs' offices. The top neuros concluded it IS the result of TOS nerve damage. Only Dr. Annest and another UCLA fellow disagreed. But the others - one of which is world renown, have absolutely no doubt and my write about it later.