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| Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie. |
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11-04-2006, 12:24 AM
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One menuvor for testing a TOS type syndrome is a Hands up, Or Stick um up position.
but get the position correct to have the results right. raise your arms up like you are being robbed. BUT bring them back in toward the spine UP AND BACK. The reason I say this is you will be protective of the position and let the arms go forward geting a false negative result. So pull the arms back to feel it in your back. Hold them up for three minutes or as long as you can open and closing the hands. What happens, what do you feel where. Does it go to the elbow hands, are the arms tired and fatigued? Is there numbness tingling? How are you with washing your hair, talking on the phone and doing activities with your arms out in from or overhead? What about an area on the collar bone about midway from the shoulder and center chest. over the back of the collar bone press inward a GOOD PRESS. You can feel around for the spot, if you are experiancing a TOS brachial compression this will be a super sore spot. If done right by a doctor you will feel it down to your ahnds and elbow. That is how to tell the ulnar from a brachial compression. If pressed there and it goes to elbow, brachial compression. If nothing happens and you press at the elbow to get the feeling to the hand then it is ulnar. This is the double crush or multiple crush. The nerve cell is three feet long all the way to the finger tips, anywhere a hinge is it can be compressed. The EMG is an insensitive test to TOS as it test the larger myliented nerves that MOVE the muscles, these larger nerves are the later affected nerves. The first affected are thw smaller myliented or sensory nerves which are not able to be tested on an EMG. The larger nerves tested are the ones if you feel heat of a candle and the arms jerks back. The smaller sensory ones are if the candle burnt you and the skin is blistered and the hurt pain signals are felt. There is a NCV test that a probe is placed in the collar bone area and signals sent to a reciever in the palm. At times the right doctor doing this correctly and the TOS has progressed you will pick up the brachial nerve damage reading. Tom Tolson has a published article relating to this. He is the doctor in our area that came up from Phila area to do the test here. He did my sons today. He did mine and the DIL recently. I hope you get some answers, but I think I mentioned to you; you may have had a pre-exsisting condition, but you had not disabled from it. The job you are doing now could be the reason for pain to a disability level. The nurse had no right to be biased, just take care of yourself. If this is a nerve injury they do not grow healthy new nerves. The assult every day at work could cause permanant damage unless action to avoid further damage is taken. I hope you feel better soon and get pain control and help from a good doctor. This is from our first Brain Talk forum and the Doctor that has treated my daughter and I for about 10 years. This response submitted by Allen Togut MD> on 3/28/99. EMG is a very insensitive way of diagnosing TOS. The EMG looks at muscle fibers, which are supplied by large, myelinated nerve fibers which more often than not involved late in the course of TOS. TOS usually first affects the small unmyelinated sensory fibers, and the little large myelinated sensory fibers which an EMG does not see. __________________________________________________ ______________ Double and triple crush This response submitted by Allen Togut MD. on 4/17/99. To understand why people devlop entrapment at more than one level-that is TOS, ulnar cubital tunnel, and carparpal tunnel syndromes, one needs to know that the nerve cell body-sensory nerve extends from just alittle outside the spinal column all-all-all-all the way to the place where it receives sensation. That is a long way. That is a long cell. And therefore it can be affected at one or more places-brachial plexus, ulnar at the elbow, median nerve at the wrist. And frequently what causes a problem at one level will also cause a problem at the second level. And moreover, when one area of the cell is affected this facilitates a second area. And lastly, diabetics are more prone to have double crush syndromes. Sincerely, Allen Togut MD. __________________ Dianne-------
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. Pocono area, PA . . . |
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11-10-2006, 04:22 AM
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very informative thread!!
Thanks Dimarie!! G~ |
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menuvor for testing a TOS syndrome Dr T posted info
bump up for newbies!!
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