Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Just Diagnoised with TOS

frenchfriffrenchfri Posts: 325
edited 06/11/2012 - 8:55 AM in Upper Back Pain, Thoracic
Hi Everyone,
I have been on this site since my ACDF surgery 12/9/2010. Mainly on the recovering from surgery section. Unfortunately it is time for a new location. Hope to get some wonderful advice but not happy to have to be here.
My neck is in pretty good shape but started having issues with my hands and shoulders around the 4 month post surgery mark. My hands started turning ice cold, reddish and white and fingertips blueish. My right hands is slightly swollen where I can't make a tight fist in the morning. My shoulders, pecs and traps are painful and tight. The ROM in my left shoulder isn't there. (I can't put my left arm around my back in order to itch or wash.
The issues with my hands and not resolved themselves independently or with medical help. Went to a vscular surgeon at my OSS suggestion - dopler showed good blood flow to the left hand. Then to a hand surgeon in April. He tool the wait and see approach since I wasn't in enough pain. I went back to the hand surgeon this week. Hated having to wait 1 1/2 hours which puts me in a bad mood. I felt he gave me more time than he did the last time I saw him. After reading the report I do not feel he put in my concerns or everything he told the woman taking the notes. SO I need to call back about that. One of the tests he did was Adson's test which is used to assess for the presence of Thoracic Outlet Syndrome at the scalene triangle. The examiner palpates the radial pulse while moving the upper extremity in abduction, extension, and external rotation. The patient then is asked to rotate her head toward the involved side while taking a deep breath and holding it. A positive exam will result in a diminished or absent radial pulse. I copied and pasted this info. I tested positive in both arms although more-so in the left hand. The color changes and coldness are not as strong as they were in the past but still quite sisgnificant. But now I feel my right hand is more swollen than it had been, not horrible but enough for me to notice. The hand surgeon wants me to go for physical therapy for 4 weeks and then go back to him. (I have been going for TENS, heat and massage for a month and I can't do that and PT at the same time due to insurance. I am going to bring the PT script to them and see what they think. They are holistic and have been really helping my knots and tightness). He also took x-rays which looked good on my left shoulder. He said there were other tests that would show more info (MRA, angio... CAT scan) but didn't want to perform yet. I told him I do not want to put off testing until issues get much worse which I did with my neck. Never a dull moment. My ROM is pretty good once the day gets going. First thing in the am I am very tight, but after a few hours and exercises I am looser and better. Went back to the 2 pound weights in the Left hand and 5 pound weights with my right hand. I thought I would be stronger by now. I feel they are still so weak. As with you , I want all of the pain and discomfort to stop and feel good in order to participate in life to the fullest. I know that you understand. There are days that I wake up in pain like prior to surgery but those are few and far apart. But it scares me when it happens.
Have a Painless Day. :)

12/9/2010 ACDF C5-6 C6-7 with plate, screws,
BMP & bone fragment filled cages
2/14/2011 trying to go back to work as a teacher
2/17/2011 starting PT
wearing bone stimulator 4 hours a day
DDD, arthritis, herniated disks, pinched nerves
3 months saw a little bit of bone growth (YEAH)
4/15/2011 Home Tens Unit
6/2011 end plate growth no more bone stimulator
pretty good ROM
still working on the strength
some issues with knots and spasms
Hands turning red and bluish and cold
8/2011 Hand surgeon feels I have TOS ( 2nd visit since 4/2011)


  • I'm sitting here in shock because I was just going to post basically the same thing you did!! I had a herniated disk at T1/2 and had a microd, lami and forenotomy about a 1 1/2 ago. Before that I had rotator cuff repair. Neither provided long term relief of my shoulder and arm pain. For the last year I have been bouncing from med to med trying to find something to dull what they think is nerve pain from the disk.

    Well last week I went for an IME and the doctor asked if I had been tested for TOS. I said no but I had asked my ortho about it after the rotator surgery and he brushed it off. So he did the pulse test and said he thinks there is a good chance I have it on the affected side. So he recommended seeing a thoracic/vascular surgeon for further testing.

    Today I saw my neurologist and told him about the IME. He did the same test but without me holding my breath. On the affected side he couldn't get a pulse when I turned my head!!

    So now I am just waiting for the IME report and will look for a good specialist. It would be nice to find a definative answer to my pain. And who knows...maybe they can relieve the pain without all these meds. So the moral of the story is don't stop looking and questioning.
  • it took two years to get a firm diagnosis .i have found the best way to relieve pain in your shoulders is by using voltrol gel and get some one to rub it in hard the harder the better .also stretching help .you will find that it comes and goes .its very painful when it flare up .do you have an extra rib? {i have} what ever you do DONT have the operation unless you end up with an aneurysm {then you will have to have it} my doctor told me that is a very serious operation and he would avoid it at all cost .you mentioned TENS .get yourself an acticare its a high end TENS and the only external spinal cord stimulator PM me if you want any more info
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • What is an IME?
    I went to a vascular surgeon in April and he only did the dopler on the wrist and said that there was good blood flow to the hand. Then he felt he heard an unusual heart beat and sent me to my PCP who is a cardiologist. I have MVP. That caused many unnecessary tests and stress to find out I have 1/3 of my beats as premature. No issues since I don't other have symptoms.
    What testing would the Thoracic/vascular surgeon do? The hand specialist wants me to have PT for 4 weeks and then come back. I told him I would prefer to have additional testing sooner rather than later. I go back to the OSS on Aug 17th for my 9 month post op appointment. I will ask him for other recommendations what where to go from here. Wondering if the stress or trauma from the surgery could have been part of the cause of the TOS.
    Being proactive with questions, doctor visits and not to give up. Keep me posted and I will do the same. :)
  • An IME is an independent medical exam. My original injury was from a car accident so my car insurance is paying for my medical. But every three months I have to go to their doctor who decides if I still need treatment. Usually these doctors are biased in favor of the insurance company and will stop treatment as early as possible. I'm lucky that I see a neurosurgeon who is very honest and cares. He has made several suggestions over the past year that I have been seeing him.

    I believe he said to go to a thoracic/vascular surgeon to get further testing. He also mentioned something about a dopler test on the pulse. He also said they can do an EMG to see if the nerve are affected. I am going to contact my internist to get a referral since my neurologist doesn't seem interested in pursing this possibility.

    Tony how do you place the tens pads to get relief? I have a unit but haven't used it much. I've been using lidoderm patches to get some relief and i have the voltaren gel also.

    I had a chest xray last year and no one mentioned an extra rib. But I did have damage to the pedicles at T1 and T2 during my surgery. So it is possible that this is causing some issues with the first and second ribs.

    Hopefully I can get some answers. It is just so frustrating when your doctor doesn't listen.
  • Kris, I also have a TENS unit. I was using it on my shoulders, upper and mid back a few times a day for 30 minutes. I change the intensity based on how each area is feeling. The holistic massage therapist said that I could use it on the area in the front by the collar bone. Haven't done that yet. I feel it helps my back and neck. I don't have the extra rib and my shoulder xrays looked good. I was also concerned that this was brought on by my surgery. Time will tell. . . maybe.
    Have a good day.
  • Hi frenchfri - my PT guy was checking me for TOS in July but was able to find the radial pulse strong on both sides so ruled it out - good luck with it -- hope they can give you some additional treatment for it to help your hands!

Sign In or Register to comment.