Hi T,

I always have more questions LOL.

What kind of work or activities do you do?

Any falls, car accidents, whiplash etc to upper body at any time {even yrs ago}
If so how do you feel about chiropractic? an expert only of course , or perhaps an expert/advance PT.

Do you recall what you might have done to bring on the flares, sometimes we have delayed pain - hrs to a day after an activity.

It sounds like you are experiencing some effects of trigger points.

next I'll post our useful info sticky thread - it's full of saved and very good info - post # 1 is like a crash course for TOS {and related conditions} with various therapies , so be sure to check it first.
http://neurotalk.psychcentral.com/thread84.html

dr & PT info sticky -
http://neurotalk.psychcentral.com/thread135.html

Nice to meet you I hope we can help you get relief soon.

Hi there,

I am someone that has TOS as well as a cervical problem. It has taken me a long time to distinguish between the two in terms of what is causing my pain at the moment. For me, the two are connected.

If your doc is not amenable to investigating further I would try to see an ortho (thats who first dx my TOS) or a spine guy.

An MRI is great but sometimes when lying static they cannot see what goes wrong when you are moving.

Ask your doc or the new doc for a flexion extension x-ray of your cervical spine. That way they can see if there is a subluxation or bone spur that is pressing on any nerves.

Also ask for an EMG to see what nerves may possibly be affected.

Also ask you doc to do the test (I forgot the name) where they hold up your arm and take your pulse. If is disappears while up that could indicate TOS but it alone should not be the only test.

And last ask if you might do a physical therapy session with someone familar with TOS and neck issues.

Good luck.

Oh I forgot to ask about your posture???
esp upper body, but the whole is an important thing to be aware of also.

shoulders hunched or rolled forward?
head forward of the body?
one shoulder higher, lower or tilted- same with hips

I have tilted/uneven shoulder, hips, ribcage - I remember when I started wearing 2 pc swimsuits as a kid- my ribs weren't even then.
not obvious to everyone but to me it was.
I may have had this tilted thing since birth..
I was also a tomboy and played backyard sports, rode horse, motorcycles, jumped out of trees and off roofs- so all those probably aggravated any minor spine things.
Landed on my head one time @ age 15 - mild concussion.

Then turning 40 and doing repetitive work for 10 hr days for many yrs - not a good thing.

I believe that test is called Allen Test check this website out.....http://www.nismat.org/ptcor/thoracic_outlet
good info there

Other testing would be a Doppler ultrasound of your armpit area to see if your blood vessels are involved. If you have changing colours of your hands chances are there could be vascular involvement.
best of luck with your searching. It took me about 15 doctors till I got a neurologist who know what he was doing and understood all of my issues....a long 3 year battle...but it paid off. I got sent to a surgeon and had the treatment necessary for my TOS.

Always remember we are all totally different even though the same name is on the syndrome. We all suffer in different ways but usually in the same spots and usually with activity and things that trigger our pain!!!
Good luck!
hugs,
Victoria