Hello everyone! I am new to the board. My name is Rachelle and I am a 30 year old female that has been suffering with symptoms since I was pregnant with my son in 2006. It started with chest pain in April 2006 and progressed the more and more pregnant I got. When I was 8 months pregnant I was having HORRIBLE pains in my left shoulder/arm. No one could tell me what the problem was, even after numerous tests. All my doctors where concerned with heart problems, but all tests proved that my heart was fine. The left arm pain never did subside, it wasn't until this May that I finally got a diagnosis of TOS. This was after my diagnoses of MVP, hiatal hernia, GERD, and gallbladder problems, they even took my gallbladder out last September.

Anyways, I am writing this because after I was diagnosed I was sent to physical therapy for about 3 months. I felt "better" but my symptoms were still there a little. I have an elevated left 1st and 2nd rib in which they would "mobilize" it back down. I worked on my posture and strengthening of my left shoulder to keep my ribs down. My therapist d/c me after 3 months because she said she would never be able to cure me and that my only hope of recovery was surgery to remove my 1st rib and scalenes, the thoracic surgeon agreed with her. With having a 2 year old to care for this all seemed a little traumatic. I was pretty much told either have the surgery or live with it. I have been doing okay until recently. I don't know if it is the cold weather or stress but I have been in a lot more pain lately.

Symptoms:
chest discomfort (feels like a tightness across my chest)
L shoulder pain
Neck pain
L bicep pain
Tingling in pinky and ring finger
headaches
fatigue

I am concerned because these symptoms are also attributed to heart problems but I have had numerous testing and consults with 3 cardio's to rule out anything serious (I do have MVP, which I take propranolol for). I can not find anything on the internet though about chest discomfort being related to TOS and no one seems to know enough about TOS to answer any of my questions (I actually work for physical therapists and they all tell me "I don't know"). Has anyone else had TOS as a result of pregnancy? I am so lost and confused, why can I go about 2-3 months with minimal symptoms and then "BAM" get hit again. Sorry this is so long but I don't want to leave anything out. If you want I can post with all my tests I have had done since my son was born to diagnosis TOS/rule out other diseases. Thanks all!!

Rachelle

hi Rachelle
You've come to the right place. We've got lots of answers and hopefully some ideas that will help you stay more comfortable.

Yes - cooler/wet weather will make you feel worse. I felt almost normal most of the summer but as soon as the weather changed to chilly - bam!

Yes - extreme muscle tightness or spasms CAN make you feel like you are having a heart problem. {also read about trigger points & referred symptoms/pain}

I'll add more but want to get this posted while you are still online....

Jo,

Thank you so much for your quick reply! You already made me feel like I have come to the right place. Thanks again and I look forward to getting to know everyone in the future!

Rachelle

You didn't mention what your pain levels are on average?

Unless you are very uncomfortable and in moderate to severe pain on a daily basis most of us here would not suggest surgery yet.
Usually surgery is indicated if you have an extra cervical rib, or vascular compression that might cause clots. You didn't mention any problems with swelling of the arm or hand so I'm just going by that- that vascular is not a major issue in your case.

Scar tissue regrowth after TOS surgeries is one reason to not go into surgery too quick. {causes probs down the road}
The real expert TOS docs/surgeons are few and far between. This is not a operation that you want inexperienced surgeon to do on you.

Does anyone in your group focus on bodywork as a whole {alignment/posture}, trigger point, myofascial work/release...

Are you home with your baby? That is so great if you are able do it.

some books/authors & most have websites too-
Sharon Butler - Book - Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries- has very good stretches for all RSI /TOS with info on posture causes and corrections. She has detailed stretching ideas to gently coax the damaged tissues to release-not to force them. website: www.selfcare4rsi.com
{ I did her TOS program many times a day even while @ work on breaks in the restroom- it is still the main thing I do at home when i start to feel any sx coming on}

Pete Egosque -his books { in most libraries} site- http://www.egoscue.com/global/where_pain.php
{ just got this book as I have some hyper mobility and get "out" of alignment quite easily - seems to be helping me feel more comfortable}
our useful info sticky link -
http://neurotalk.psychcentral.com/thread84.html

Jo,

It is hard to say what my average pain levels are because I was doing really well before the cold weather set in. When my TOS was at its worst a few months ago probably about 6/10 ( I do have high pain tolerance....had a c-section and took NO pain meds after ) I do have intermittent swelling in my left forearm, I can't believe I left that out, that is why they tested me for TOS. My veins become real distended in my forearm/hand and sometimes it hurts (have not had problems lately).

I work 20 hours a week at a PT office as the receptionist, unfortunately my boss has a policy that the PT's cannot work on coworkers.... so I am forced to actually go to PT, but all I really need is mobilization, I still do all the exercises they taught me but they are not helping right now. I can look in the mirror and tell that I am EXTREMELY elevated...oh well.

Thanks again for answering my questions, I greatly appreciate it.

Rachelle

I found an independent advanced PT that really helped me a lot and he was the one that tried the rib mob on me - awesome results with that!
I have been going to a very good chiro for 4 yrs now, wow time flies...
he uses a variety of therapies as well as adjustments and after the PT did the rib mob I told him about it so now he always checks that.
But the chiro is the one I found after I had very severe spasms- my upper body was really locked up , I didn't know what it was at the time
He was so concerned and helpful , after some 2x a week appts he got the spasms under control and we could taper back the appts til we got to monthly - that seems to be the time line where I need to stay at.

Welcome....sorry you have to be here, but you will find it a wonderful place full of really smart and caring people!

Have you had a doppler ultrasound of your brachial plexus to rule out vascular involvement. With the swelling you are describing you could have vascular compression and that needs sorting our ASAP. if u do have vascular tos you are at risk for clots and stroke....not to worry you but it needs looked into asap as I said.

Have you had a simple chest xray to look for cervical ribs? perhaps you are one of the lucky ones. During your pregnancy your ribs get compressed due to the growing little one and that could have been an issue for you especially if you have cervical ribs. All you need is a chest xray to get that discovered and ruled out or in.

have you had an emg?? it can tell a lot about the compression you may be having. Usually us tos'ers have normal emg's but there are a few who have had really bad tos that has lasted for a long time and loose nerve function.
This is a fast and realatively painless test as well.

just a few things to think about.

take care and welcome again!
hugs,
Victoria

Hi rmurphy7978,
I have similar symptoms, please consider the following reason for your TOS.
1. The pains in the chest are due to costachondritis
2. The costachondritis is caused by a costavertebral problem
3. When there is irritation and inflammation at the joint between the rib and the vertebra the scapula stabilising muscles which at this attach at this position will not function properly>> destabilising the scapula>> precipitating pectoralis minor syndrome (hyperabduction syndrome)
4. Chest breathing (paradoxical breathing) which often accompanies TOS can cause GERD and vise versa
5. Non steroidal anti-inflammatory drugs (NSAIDS) can cause
a. GERD problems
b. Breathing problems
6. Pressure on the diaphragm (sitting, being pregnant) can cause chest breathing (paradoxical breathing)
7. Chest breathing (paradoxical breathing) will exacerbate the costavertebral problem
8. Neck muscles which attach to the same inflamed thoracic area will not function properly stressing compensatory neck muscles causing neck and head aches
9. Sleeping (laying ) on the affected ribs will be uncomfortable and exacerbate the costavertebral problem
10. Not having enough sleep and continually chest breathing will cause fatigue
11. Using the arm which is on the side of the costavertebral problem will cause the scapula stabilisers to be continuously irritating the affected area.(stressing the joint)
12. Having a
a. job with over head work
b. job which requires hours of postures with arms out in front (typist)
c. hobby such as musician (continuous stressful arm postures)
d. Sport that stresses this costavertebral joint
e. young child which will not allow one to let the joint to heal or the irritation to subside
can cause the condition
If you focus on not irritating the that joint (it is not easy) you may have an improvement in your situation
Try this site for another understanding
http://www.spine-dr.com/site/alt/osteo_article2.html

Good luck, Towelhorse

Dear Towelhorse,

I have be striking out with PT, chiropractor, acupunture.....

I found your observations insightful and was wondering if I could talk to you offline to talk about your method of recovery from bitateral TOS. After my own research, I am arriving at similar root causes (i.e. stiff thoracic spine, chest breathing, tight scalenes, pec minor, winged scapulae, am many muscle knots between scapulae). I hope to hear from you.

Best Regards