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


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Old 05-09-2008, 03:34 PM #1
TraceyW TraceyW is offline
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Talking Im confused about cause of atrophy....

Hi all,

Various dr's have commented on 'atrophy of thenar eminence' on my right hand -....i think that this is the area near the thumb joint?. The padded area of my thumb did waste away a bit when i first had my symptoms a few years ago - and since the thumb area leading upto the wrist (if that makes sense!)has become bony looking and i can feel the 2 seperate ligaments where i suppose the muscle in between has wasted. (i never used to be able to!).

im confused as to whether this particular symptom is caused through vascular or nerve TOS?

i have read several links on here and on my own google searches which conflict.......

x
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Old 05-12-2008, 10:33 PM #2
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this is most generally a neurogenic symptom where the impaired nerve cannot activate the muscle for normal usage, and in time the disuse naturally causes atrophication and tissue loss
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Old 05-12-2008, 11:53 PM #3
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I agree with Richard's explanation.

My chiro explained to me that the nerve & muscles can interplay quite a bit -
with one affecting the other, as well as the blood supply to an area also.
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Old 05-13-2008, 11:39 AM #4
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thanks to you both jo and richard!.

im still just getting confused about all these symptoms as seeing my most recent EMG came back as normal. The one i had 2 years ago (the atrophy was noticed pretty much 3 years ago now) said there was some indication of interference at some point!....i was confused about all that and didnt ask for any more clarification - had never even heard of TOS back then either!

so from what i understand, the interference with the nerves can be on and off with TOS (in some people there is no permanent entrapment?) but on/off interference can cause the muscles not to function properly and eventually cause muscle wastage?

my little finger has also started becoming a little swollen looking, this seems to be staying with me and not going for the last couple of months and im quite worried about it now! - this is vascular i believe, but again it depends which website i read!
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Old 05-13-2008, 12:04 PM #5
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I found that no one website can even begin to cover all the variations of TOS .

I think my version must be mostly due to sticky myofascial tissues - because when I keep up with my self care and stretches and ergonomics I do OK.

But as soon as I skip them for a week or do heavy/intense projects - I can feel bad things starting to happen
my typing gets really bad and I hit all the wrong letters as well as getting sore and achy - if I continue on without doing any self care- then the trigger points will start to appear.

Sooo If you ever can get to a place when you feel good -
Do not slack off - keep up with what helped you to feel good and stay with it.

DiMarie has a good explanation why EMG don't really work to show TOS
something about the small nerve or sensory nerves don't get tested only the major nerves & if the problem is in the smaller nerves it doesn't show up.
just my quickie version...as I can recall it
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Old 05-13-2008, 02:56 PM #6
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Thanks Jo,

Im going to mention that to my Dr about the smaller nerves and see what he says as no one has mentioned it from that point of view before....

Think im probably not going to look at all the websites too much - or at least take them with a pinch of salt!.

I have limited myself to the activities i can do...its hard though to explain to people that i have to come home from work to rest before i can go anywhere else - if i dont rest then i end up in pain....they think im an old person at 26 yrs old! I feel like people dont understand why i cant carry things etc and think im just lazy or exagerrating my pain...its so fustrating!

im going to post another thread about MRA's - i had one almost 2 weeks ago and if it comes back negative i want to know if its worth me pushing for another test - ie, doppler...
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Old 05-13-2008, 03:15 PM #7
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I found DiMarie's post about EMG testing-
http://neurotalk.psychcentral.com/sh...light=EMG+test
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Old 05-13-2008, 09:24 PM #8
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Hi Tracey,

Go the dopple test. This was the test that showed up my TOS straight away. I dont know what at MRA is? Iv only ever had the doppler ultrasounds which were positive on both arms.

Good luck.

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Old 05-14-2008, 12:56 PM #9
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Thanks ozzy!

An MRA is the same as an MRI except it looks specifically at the blood vessels (they put an intravenous line into my arm and fed through contrast dye whilst i was in the machine). i went through once with my arms by my side and then went through a second time with my arms over my head.

i think it wont show anything and that i will need more test - i will push for a doppler or angiogram....why cant they just sent me for the best test the first time!....its sooo fustrating!
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