Hi, I just want to toss this out as I can't get a single generalist or specialist to look at this holistically. Here is the vital info. I'm 40 and was in a traumatic car accident in 1990 which resulted in fractures of c7, t1, l5. Aches, pains, strains during the 90's starting early 2000's I began to throw out my thoracic spine on a monthly basis & received chiro treatments. I've always been athletic and competed in many sports. I still weight lift, do cardio and martial arts but about the time my back began giving me problems I began experience what I would define as muscle rigidity. Because of martial arts I can do a full split so I'm very flexible and yet I have experienced <10 tears (pops) in my calves over the past 5 years, between 5-10 pulled hamstrings, chronic forearm strain (lifting a glass of water causes pain), chronic elbow tenderness, crackling/aches in both knees and about 6 months ago more trouble with my back but this time the lumbar. Everytime I get healthy and start to exercise again it's another injury.
My weight has steadily increased although not entirely due to injury as I find alternatives and work around each injury. I'm now about 260. For frame of reference a good bw for me is between 215-220 where I was about 5 yrs ago at 12% bf.
The answer may be the obvious but even though I have a high pain threshold I'm tired of hurting and waking up in pain. Every part of me hurts, I've gained a lot of weight that doesn't respond drastically to diet restrictions and my energy levels are decreasing. Any correlations I should consider?
Sorry for being long winded and thanks for any help you can give.

Hmm Chris, my reaction isn't RSI with the history you've given. I'm wondering if its fibromyalgia.... I'm no expert though!!!
Could you talk more about your elbow tenderness and what kind of work and activities you do that could be considered repetitive?

Here's what I used to post all of the time:

I don't think any of my tests came up abnormal except the scalene block was positive for taking away the pain - and the high, high pain was the primary symptom - and, blood tests, obvious color changes on arm skin, loss of use of the hand / arm, temp changes, and where I pointed out the pain locations copied known TOS patterns, and differing blood pressure from one arm to the other. So the docs put all of those facts together, with the absence of any other known diseases, and concluded neurogenic TOS.

TOS is a diagnosis when ALL other testing does not show an obvious orthopedic or other reason for all of your symptoms. You may test normal to ALL of these tests but still have neurogenic TOS. (Vascular TOS alone is only about 5% of all TOS cases, and it is seen by the abnormal vein imaging.) TOS is a diagnosis when you have ruled out all other problems, because if you do not do the foundational TOS tests to rule these out, then you might have missed an obvious tumor, etc., which could be life-threatening. Yet it does not mean that TOS is merely what you call it when you are done with testing. Testing is extremely important. Normal results in all, can still conclude TOS, if the proper symptoms are present as a whole. There is no single, one-shot test for TOS. You can't usually "see" it.

I am not a doctor, and this description of tests is just "laymens' terms."

1. You should have ruled out any rheumatological or immunological conditions by seeing a rheumatologist and having these blood tests run. Sometimes they will run a brain MRI to rule out MS or other copycat conditions.

2. Neuro / ortho / vascular doctors do MRIs of the neck, brachial plexus, shoulder, hand, etc., looking for any obstruction or strucural abnormality. These MRIs can be run with fluid, and may or may not have your arms in differing positions. Mostly, these are for finding any arterial or vein blockages.

3. Xrays are also ordered of the spine, usually in the beginning, and a few TOSers will have additional cervical ribs, but many do not. "Extra cervical ribs" or "protruding cervical ribs", etc., are the terms to listen for.

4. Neuro docs do EMGs and nerve testing, including SSEPs, each one believing that only their way is the right way. Usually, it is not always going to show anything. You want to ask if they test up by the neck for the C-8, because if this is slow, the C-8, it tends to show TOS rather than cervical radiculopathy.

5. Doppler tests are like sonograms of the arm to see if there are any blockages of blood flow. You can have neurogenic TOS and still have vascular / circulation type symptoms, but these may not show up on this test. Blockages must be treated usually by surgeries, ASAP.

6. MRAs or MRIs with fluid involves cut-downs along the arm to track blood flow, as you sit or stand. In my case, my nerves were wrapped around my double veins, so we were unable to cut-down all the way up.

7. 3d MRAs (or is it MRIs? I always get this one wrong.) By Dr. Collins shows different angles of the brachial plexus at such a high resolution that doctor is able to "see" compressions, impingements, etc. However, most of us do not get this luxury. (I think the cost is $7,500 right now?)

8. Scalene block - if you feel relief for a brief period of time, this is positive for surgery.

9. Thyroid issues - many TOSers are hypothyroid. Some show up easily on a blood test. Others, are not shown on a blood test. Some are called "Hashimoto's thyroid" such as mine. Mine were based upon symptoms, rather than numbers on a blood test. They incuded: dry hair, or slow growing hair, depression with no real situation or depression that has gone on a long time, nails that don't grow or are brittle, dry or flakey skin, sleeping 10 or 12 hours or a whole weekend like I was and still tired, not being able to sleep at night, tired when forced to wake up, (once I started the thyroid, I slept from 11 AM to 7 AM without problem), slow bowels, like not moving for a week, (not really weight gain or weight loss, though, this wasn't about being fat, but about not good body metabolism.) So anyways, this is a subject for you and your doc.

If all of these tests come out basically normal, this leads to discussion of TOS as the culprit. It is especially hard to tell the difference between cervical ortho causes and TOS, and sometimes shoulder and TOS. But you must go through time-consuming testing to find out all of the results, because if you simply proceed with an ortho surgery, your TOS pain can go through the roof and you can have unexpected complications, so it's rather serious to proceed now with great caution, whereas the work comp ortho surgeons love to "cut and run!"

We have a ton of articles post on the upper left hand corner.

We also have listed some of our docs we have seen, on the upper left hand corner. In my opinion, most doctors ho say they know TOS can NOT diagnose TOS, and I went through over 10 orthos / neuros / vascular surgeons who did not diagnose me, and it wasn't until I flew to Denver and saw Dr. Annest that I got a diagnosis, and then most of these docs said "oh, that's what I thought, too, but didn't want to be the one to make the diagnosis."

Pain control is another big fight.

Be very wary of chiropractors who say they can "cure" TOS. Do NOT do any physical therapy or treatment that hurts you, or tries to strengthen you. TOSers (for the most part) cannot do strengthening exercises, cuz that causes swelling, which is already a problem.

The best physical therapy that I know of is the "Edgelow" system, he is listed in our doctors list in Berkeley CA. Many P/Ts do his system. You can get it via mail, too.

Try to figure out how you got TOS, if you do get diagnosed. Were you in an accident to the collar bone area? Or, were you doing a job that had a lot of repetitive hand / arm movements over an extended period of time? IF you can't say why you got TOS and you're working, presume it caused the TOS, and make sure to get an attorney consult and proceed with a claim. Do not wait, no doctor will take care of this aspect for you. The onus is on you to pursue your work comp benefits, which, sometimes TOS is 100% disabling condition.

In reading your post, I don't see the normal top 5 symptoms of TOS.

We have hand pain, arm pain, top of shoulder pain, a pain "spot" right by the shoulder blade, horrible neck pain and headaches, and fatigue, as in not being able to get out of bed for days. (I am bedridden 90% of the time.) But my TOS all started by using the computer too much and getting hand, wrist, thumb and elbow pain on the right side.

Just in case, I posted all of the tests they put us through for TOS. This may give you some info. to know what kind of doc you want to see - I'd think an ortho and a rheumatologist would be a good start, with some spine imaging (MRIs) and get some immunological blood work to make sure you don't have the "usual" MS, ALS, MD, etc. - they just RULE THEM OUT, so you can move on to more issues. Same with ortho MRIs, they are looking for disc damage that can be linked to your pain.

I hope this info. helps you.

Hypertrophy of the neck and surrounding muscles can be a factor towards TOS type of symptoms.
Do or did you focus on a high development of those muscles?
Hypermobile joints are prone to RSI and other problems...

As mentioned finger, hand, arm, shoulder, neck and upper back pain are the primary symptoms of TOS .

You could have full body sticky fascia or maybe even scar tissue or something totally different??
I think a full work up as suggested would be a good idea.

Maybe a change to yoga and stretching and walking might be something to try when you are on the mend again.