Very complete review for a difficult and complex condition. Many TOS surgeons do not believe that TOS can occur in upper brachial plexus distribution, which is incorrect. I am glad you pointed out the distribution in symptoms in each case and the "diffuse" symptom pattern distribution
Oh my... that must be the explanation to my issues! And here I was sitting in fear, for months, there would be a tumour compressing something in my chest or back, armpit or arm... this video is a true revelation because none of my doctors nor my chiropractor seem to think about this.
I do have cervical issues, however current pain is as you described for upper plexus involvement. Has been there months of the worst pain I've experienced, and I have had many disc, canal and foramenal issues. I can see why folks opt for that major first rib resection, scalenotomy and pec release, as barbaric as that seems. Appreciate your insight and info. Ease and grace.
TOS is very brutal. I have it. It was from being rear and being thrown into a wheelchair lift March 2014. My last day of work was 11/29/16. First rib resection & scalenectomy on 12/16/16. Pec minor release 11/25/17 and revision surgery 4/15/19. I’m still out of work. Having a port placed for IV access for SGB blocks, potential spinal cord stimulator and ketamine infusions. I have developed RSD as a result of everything.
Thank you for this video Kai. I wish I could talk with you! I was diagnosed with cubital tunnel syndrome with a severe lesion at the elbow, sensory and motor loss, and muscle wasting in my RT hand. However, the hand surgeon performed Adson's test on me (positive) after I kept pointing to the throbbing lump at my collarbone and described the neck/shoulder/arm pain I had been experiencing for 17 months. He sent me for a TOS eval. I have an arterial doppler ultrasound scheduled and was told it was OK to move forward with the ulnar nerve decompression surgery. Could it be that TOS has caused ulnar neuropathy? I've read about TOS cases with a double crush syndrome, often affecting the median and ulnar nerve. I also had mild carpal tunnel according to the nerve conduction. Can you have both TOS and ulnar neuropathy?
I've had bilateral carpal & cubital tunnel release, and now 2 years later, having recurrence of bilateral numbness on 3rd,4th and 5th fingers. I was sent for another emg and neck mri. 🤔
I know I have it. It's getting worse too. Chiropractors seem to not be too familiar with this condition. I've been to several and pinched nerves are rarely mentioned. I've dealt with it for 26 years now, and it only seems to be worse. I've tried everything.
@Angela Hall Have a look through MSK neurology's RUclips channel. He also has an article on his website about TOS and talks about it very specifically and how he thinks it should be treated. Give it a look I hope it helps you
This is interesting- I had vascular and neurogenic TOS (arterial, venous, and nerve compression). Classical EDS and former elite gymnast….a perfect storm.
EDS ? How’d u get diagnosed ? I apologize for such a long msg but I’m desperate & maybe u can help or give advice. So I’m 39 & was diagnosed w/severe pelvic organ prolapse @27yrs old. Docs said I was 2young for it 2b so severe. Finally found a doc to fix it & had surgery 2yrs ago. Recent tests show its all broken again so I need revision surgery now. A gastro mentioned EDs Yrs back. I never heard of it & thought he was nuts. Once I got bad, I looked into eds. It makes sense this could be an underlying issue. I don’t dislocate or have probs w/being hyper mobile tho. I had a spiral fracture @7 riding my bike but no dislocations. I’m flexible but kinda stiff now. Can u have eds w/o dislocations ? I struggle to get out of bed. I’m always super tired, dizzy & weak. I know somethings wrong. My son had a growth spurt & now has pectus excavatum (funnel chest.) I read this can be caused by connective tissue disorders. I don’t dislocate but have some signs & symptoms like those white fatty deposit balls on the inside & back of my heels. My hubby’s 16yrs older & his skins way tighter than mine. I can pull my skin far off my body, neck & face. It’s wrinkly in weird places like a 70yr olds, soft, velvety, heals bad & scars easy. I get hypertrophic scars but also keloids. Ppl say I look 10yrs younger than I am. I’m having an endoscopy for swallowing probs & had an MRI yesterday. Doc thinks I slipped a disc in my neck. I’ve been dizzy & tired all my life but never played sports & had injuries. I read u can have ehlers w/o double joints & dislocations. Is this true ? Im tall w/very long arms & legs but I’m not flat footed I have real high arches. My finger joints are big & over extend but I’m not sure much else overextends. I’m sorry to dump all this on you but was excited to read u have ehlers. I’m desperate for answers & can’t find a doc to look @ me or consider testing. I need a doc to set aside his ego & prejudices & run tests to c what’s wrong. 3 docs I recently saw dismissed me the moment the word Eds came out of my mouth w/o looking at me, my skin or listening to my story & all 3 said they never treated patients w/it but doubt I have it. What’s ur story w/eds ? How did u get diagnosed, if u don’t mind ? U have classical isn’t that the type that doesn’t necessarily dislocate ? Thanks :)
@@rachelcross27I was diagnosed via genetic screening. I was referred there after hypermobile issues. I was diagnosed with classical EDS, which has a genetic marker.
I’m not sure if I have thoracic outlet syndrome my neck chest swells very big and lost function in arms but I’ve had mri and mra of neck and found nothing alarming I’m at my wits end!!
Mine was in throat then to collerbone horrendous then now shoulder blade armpits no pain down arm nowadays but in both is this toc just been badged fybro spectrum
Dear Sir, I have been diagnosed with neurogenic Thoracic Outlet Syndrome due to having a cervical rib in C7. This has caused weakness and thenar muscle atrophy in my left hand. The Dr's are suggesting a surgery to remove the ribs which sounds very scary. I started Physical Therapy a few weeks ago and I am seeing some improvements. Weakness seems to be getting better, but, not to a great extent. Can you please tell me if it is possible to fully cure nTOS by doing physical therapy even for people with Cervical Rib? Please help me. Thank you very much!
Any ideas what can be causing tightness and paresthesia in my left hand, foot, cheek. Also affects my right hand and foot. Thumbs are constantly tingly. No lesions from MRI. Nerve conduction study ruled out carpal tunnel. Could it be vascular?
قال رسول الله صلى الله عليه واله :إن الله تبارك وتعالى جعل لأخي علي بن أبي طالب فضائل لا يحصي عددها غيره ، فمن ذكر فضيلة من فضائله مقر بها غفر الله له ما تقدم من ذنبه وما تأخر ، ولو وافى القيامة بذنوب الثقلين ، ومن كتب فضيلة من فضائل علي بن أبي طالب (عليه السلام) لم تزل الملائكة تستغفر له مابقي لتلك الكتابة رسم ، ومن إستمع إلى فضيلة من فضائله غفر الله له الذنوب التي إكتسبها بالإستماع ، ومن نظر إلى كتابة في فضائله غفر الله له الذنوب التي إكتسبها بالنظر
here I thought with the left bundle lower heart was the reason for the burning pain in my upper chest and radiates down my left arm el bow, last two fingers and at times the thumb and the top hand inside wrist area at times and can also be moving to the opposite side across collar bone into should bothsides. Is the the TOS radiating pain?
because the signs and symptoms associated with the nerve compression can be caused by many different problems. Saying syndrome is a way to organize in the medical field
Sorry guys, but you are just repeating textbook knowledge. I would like to hear patient stories and what you physio guys did to help people like me suffering from this awful condition. Many thanks!
Most professional and knowledgeable guys I have seen .. excellent channel .. regards from South Korea 🇰🇷
Very complete review for a difficult and complex condition. Many TOS surgeons do not believe that TOS can occur in upper brachial plexus distribution, which is incorrect. I am glad you pointed out the distribution in symptoms in each case and the "diffuse" symptom pattern distribution
Oh my... that must be the explanation to my issues! And here I was sitting in fear, for months, there would be a tumour compressing something in my chest or back, armpit or arm... this video is a true revelation because none of my doctors nor my chiropractor seem to think about this.
That's a lot of information! I'll have to watch it several times to get it all down.
Amazing as always. Thanks Kai!
I do have cervical issues, however current pain is as you described for upper plexus involvement. Has been there months of the worst pain I've experienced, and I have had many disc, canal and foramenal issues. I can see why folks opt for that major first rib resection, scalenotomy and pec release, as barbaric as that seems. Appreciate your insight and info. Ease and grace.
This video is incredible man wtf thank you
wtf
Kindly make a video on different gait patterns
TOS is very brutal. I have it. It was from being rear and being thrown into a wheelchair lift March 2014. My last day of work was 11/29/16. First rib resection & scalenectomy on 12/16/16. Pec minor release 11/25/17 and revision surgery 4/15/19. I’m still out of work. Having a port placed for IV access for SGB blocks, potential spinal cord stimulator and ketamine infusions. I have developed RSD as a result of everything.
Thank you for this video Kai. I wish I could talk with you! I was diagnosed with cubital tunnel syndrome with a severe lesion at the elbow, sensory and motor loss, and muscle wasting in my RT hand. However, the hand surgeon performed Adson's test on me (positive) after I kept pointing to the throbbing lump at my collarbone and described the neck/shoulder/arm pain I had been experiencing for 17 months. He sent me for a TOS eval. I have an arterial doppler ultrasound scheduled and was told it was OK to move forward with the ulnar nerve decompression surgery. Could it be that TOS has caused ulnar neuropathy? I've read about TOS cases with a double crush syndrome, often affecting the median and ulnar nerve. I also had mild carpal tunnel according to the nerve conduction. Can you have both TOS and ulnar neuropathy?
I've had bilateral carpal & cubital tunnel release, and now 2 years later, having recurrence of bilateral numbness on 3rd,4th and 5th fingers. I was sent for another emg and neck mri. 🤔
I know I have it. It's getting worse too. Chiropractors seem to not be too familiar with this condition. I've been to several and pinched nerves are rarely mentioned. I've dealt with it for 26 years now, and it only seems to be worse. I've tried everything.
@Angela Hall
Have a look through MSK neurology's RUclips channel. He also has an article on his website about TOS and talks about it very specifically and how he thinks it should be treated. Give it a look I hope it helps you
Can you add few studies in management of TOS. Like recent advances. And what is the role of PT in ATOS and VTOS?
This is interesting- I had vascular and neurogenic TOS (arterial, venous, and nerve compression). Classical EDS and former elite gymnast….a perfect storm.
EDS ? How’d u get diagnosed ? I apologize for such a long msg but I’m desperate & maybe u can help or give advice. So I’m 39 & was diagnosed w/severe pelvic organ prolapse @27yrs old. Docs said I was 2young for it 2b so severe. Finally found a doc to fix it & had surgery 2yrs ago. Recent tests show its all broken again so I need revision surgery now. A gastro mentioned EDs Yrs back. I never heard of it & thought he was nuts. Once I got bad, I looked into eds. It makes sense this could be an underlying issue. I don’t dislocate or have probs w/being hyper mobile tho. I had a spiral fracture @7 riding my bike but no dislocations. I’m flexible but kinda stiff now. Can u have eds w/o dislocations ? I struggle to get out of bed. I’m always super tired, dizzy & weak. I know somethings wrong. My son had a growth spurt & now has pectus excavatum (funnel chest.) I read this can be caused by connective tissue disorders. I don’t dislocate but have some signs & symptoms like those white fatty deposit balls on the inside & back of my heels. My hubby’s 16yrs older & his skins way tighter than mine. I can pull my skin far off my body, neck & face. It’s wrinkly in weird places like a 70yr olds, soft, velvety, heals bad & scars easy. I get hypertrophic scars but also keloids. Ppl say I look 10yrs younger than I am. I’m having an endoscopy for swallowing probs & had an MRI yesterday. Doc thinks I slipped a disc in my neck. I’ve been dizzy & tired all my life but never played sports & had injuries. I read u can have ehlers w/o double joints & dislocations. Is this true ? Im tall w/very long arms & legs but I’m not flat footed I have real high arches. My finger joints are big & over extend but I’m not sure much else overextends. I’m sorry to dump all this on you but was excited to read u have ehlers. I’m desperate for answers & can’t find a doc to look @ me or consider testing. I need a doc to set aside his ego & prejudices & run tests to c what’s wrong. 3 docs I recently saw dismissed me the moment the word Eds came out of my mouth w/o looking at me, my skin or listening to my story & all 3 said they never treated patients w/it but doubt I have it. What’s ur story w/eds ? How did u get diagnosed, if u don’t mind ? U have classical isn’t that the type that doesn’t necessarily dislocate ? Thanks :)
Is it possible that the act of swallowing causes pain in the chest and that this pain is related to tense muscles caused by poor posture?
@@rachelcross27I was diagnosed via genetic screening. I was referred there after hypermobile issues. I was diagnosed with classical EDS, which has a genetic marker.
@@humbertofernandes2287honestly, I don’t know, I can ask about it with my providers.
I’m not sure if I have thoracic outlet syndrome my neck chest swells very big and lost function in arms but I’ve had mri and mra of neck and found nothing alarming I’m at my wits end!!
That sounds like me, though I have had three fusions in my neck
Any update?
Excellent
Mine was in throat then to collerbone horrendous then now shoulder blade armpits no pain down arm nowadays but in both is this toc just been badged fybro spectrum
Dear Sir, I have been diagnosed with neurogenic Thoracic Outlet Syndrome due to having a cervical rib in C7. This has caused weakness and thenar muscle atrophy in my left hand. The Dr's are suggesting a surgery to remove the ribs which sounds very scary. I started Physical Therapy a few weeks ago and I am seeing some improvements. Weakness seems to be getting better, but, not to a great extent. Can you please tell me if it is possible to fully cure nTOS by doing physical therapy even for people with Cervical Rib? Please help me. Thank you very much!
Hi, are you ok now
Did u do a surgery
Hello?
Ok, so which doctor do you go to to diagnose neurogenic tos?
Orthopedics in my area are lazy.
Any ideas what can be causing tightness and paresthesia in my left hand, foot, cheek. Also affects my right hand and foot. Thumbs are constantly tingly. No lesions from MRI. Nerve conduction study ruled out carpal tunnel. Could it be vascular?
Nerve tests don't always have to be positive for you to have carpal
قال رسول الله صلى الله عليه واله :إن الله تبارك وتعالى جعل لأخي علي بن أبي طالب فضائل لا يحصي عددها غيره ، فمن ذكر فضيلة من فضائله مقر بها غفر الله له ما تقدم من ذنبه وما تأخر ، ولو وافى القيامة بذنوب الثقلين ، ومن كتب فضيلة من فضائل علي بن أبي طالب (عليه السلام) لم تزل الملائكة تستغفر له مابقي لتلك الكتابة رسم ، ومن إستمع إلى فضيلة من فضائله غفر الله له الذنوب التي إكتسبها بالإستماع ، ومن نظر إلى كتابة في فضائله غفر الله له الذنوب التي إكتسبها بالنظر
Thoracic spine problems in my leg....its possible ?
here I thought with the left bundle lower heart was the reason for the burning pain in my upper chest and radiates down my left arm el bow, last two fingers and at times the thumb and the top hand inside wrist area at times and can also be moving to the opposite side across collar bone into should bothsides. Is the the TOS radiating pain?
Why is it called a syndrome?
because the signs and symptoms associated with the nerve compression can be caused by many different problems. Saying syndrome is a way to organize in the medical field
@@Bobenrieth.95 yeah I have so many diagnosis don't no what I have myofacial pain hypomobility
👌👌👌👌
👍🏻👍🏻👍🏻👍🏻👍🏻👍🏻👍🏻
Sorry guys, but you are just repeating textbook knowledge. I would like to hear patient stories and what you physio guys did to help people like me suffering from this awful condition. Many thanks!