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I am in Canada. I have been experiencing pain along with other symptoms for the past 2 years. I'm getting nowhere! A subsidized gong show.

Healthcare (in this respect) is downright archaic in Canada.

In regards to PT without weights and not strengthening until the end, my PT got 6 visits with me. Since I told her I used to be an athlete (basketball player), she thought she needed to beef up my exercises and has added weights. I haven't been diagnosed with TOS but I'm almost sure I have it after my MVA. I had 3 level disk replacement at C3-4, C4-5, and C-56. I have burning/tearing (pins, needles) in my collarbone area and upper trapezius area, along with some other symptoms. I had DSN entrapment release surgery 6 months ago but obviously it was misdiagnosed, or maybe I had that in addition to TOS. Should my PT continue with the strengthening exercises with weights?

This is so cool! Dr. Hagan is my doctor and I absolutely love him, and he mentions Patty Zorn, who is also my Physical Therapist. We are still working through some of my issues but I know I am in the best hands! Hoping to get some relief soon!

Forgot to say as far as my hemidiaphram it took a year but my hemidiaphram paralysis subsided and i believe it's all good. Pulmonary Dr said it dramatically improved only thing is now everything feels unstable.... Thank forgot to mention this...

I'm finally getting diagnosed!! about 15 years of falls and auto accidents. Mayo missed my worst problems caused by undiagnosed and untreated TOS. THey don't know to what extent i might regain what Ive lost. I'm sad and glad all at the same time

I’ve been coping with neurogenic TOS since 2017 and this is very helpful for me, it sure explains why I wasn’t getting any better. Many thanks!

This video was about hands and limbs. It's so difficult to find decent information about weakness of the thorax muscles.

Is it possible to cause Idopathic Intercranial Hypertension. If so, what test is needed to make confirmation.

Really appreciate this thorough academic perspective!

Are there any cases of tos that refer numbness upward into the face?

The physiatrist I saw said that I couldn't have tos because I don't have an extra rib. From my own research, I'm under the impression that it can absolutely happen without the extra rib.

So sorry I missed this today. I just went for my interscalene block today but arm pain is still there. Just wondering if this is pretty normal. My pain seems to be the ulnar nerve path.

Very informative! Thank you for sharing

Informative and well-explained care models.

What type of Dr would be excellent to see for this? Or a Chiropractor? Is there a website with Dr Location Listing?

How can you identify a nutritional deficiency if you never looked for it? This guy's answer is called making up BS as he goes to paper over the fact that it never occured to him and he never tested for it.

Im in Sydney, Aust. Thank you. My acupuncturist is wonderful but legally she is not allowed to touch scalenes cuz theyre near lungs etc.

I have all 3 types since 2005, many surgeries (excision of first rib, pectoralis minor removal, venograms, angiographies, medicines). This is post acromionectomy, rotator cuff surgery, LTN got nipped. Cervical surgeries in 2013 & 2017. I believe you both know my physicians in Los Angeles. I do not play sports, I am 58 now and is still suffering. Why so much swelling above and below clavicle?

Thanks for all these videos. Going for an ultrasound tomorrow for TOS.

Thank you for your videos. When I start with any physical activity I get very clumsy. It gets embarrassing, at times. The pain is almost unbearable at times. Just starting to get to the bottom of this. Will be getting an ultrasound soon. Your videos have helped me so much. ❤

anyone ever get a heartburn like feeling

well explained and straight to the point! good job

I had tos since I was a kid. I just thought it was normal tho being in so much pain lifting or whatever. Until my right arm completely blocked off. Needed the surgery to save me. Now I'm getting it in my left arm not as severe since I'm right handed

My first injection was awesome and lasted a few weeks but was somewhat diagnostic. Second injection with different dr. And had anesthetic spillover to the right recurrent laryngeal nerve (breathing, voice, swallowing, and phrenic nerve (right lung, diaphragm) issues. I had no driver, was a late injection that I hadn’t eaten so went home, tried to eat a few bites of mashed potatoes and food got stuck. Due to issues with medical systems I took meds to stop the panic attack I thought I was having but it was the anesthetic on top of the anxiety of not being able to breathe properly, went to sleep sitting up and hoping I would wake up and not aspirate on the potatoes. It was stupid not to go to ER but the system is horrible and even with ER plans I am treated poorly. I have had additional issues with these things since the dr. Wasn’t even going to do the same procedure as the first time and didn’t have the same equipment or sterile room under imaging as the first time . This Dr. Also had done a heavy handed SI injection in the past with spillover that made it so I couldn’t walk for a day …so clearly she is a no go. But I have had crazy injection reactions and medication reactions in the past (hypermobile spectrum disorder) as well. I have done PT, done injections, made a crap plan with the self professed “one trick pony” who would do the surgery for me….so I just hope I never have to go down that path. Thank you for all of the information over the last year + that I have been following!

Thank you both, and Dr. Lum, for your incredible guidance and support. I truly appreciate you taking the time out of your personal time to answer my questions so patiently. Your expertise is invaluable. While I still need to do more research before making a decision about surgery, I would wholeheartedly recommend you to anyone considering this path.

I get botox in my masseter muscles to treat my TMJ pain. I've done this for 6 years and it's great. I have tons of pain in my scalene muscles on the side where my TMJ pain is the worst. When I get massages there, my jaw tension releases and my arm goes numb. I want to try botox in my scalene muscles. What kind of doctor do I go to for a consultation for this treatment?

I was recently diagnosed with Paget Schroetter (July 3rd 2024). It has been devastating for me since my life revolves around being a rock climber and athlete. I had a DVT and 3 PE emerge seemingly out of no where. I was at Stanford for 4 days where they did thrombloysis and angioplasty & now my DVT is cleared. Got a consultation for FRR. Although I am most likely going to get surgery I am first reading a lot about conservative treatment. From reading some contemporary reports/data (TOS Book 2021 Illig and co) it seems as though some patients with VTOS do just as well with anticoagulation and thrombolysis without FRR. I am wondering if high-res imaging can help delineate with structures that are actually compressing subclavian vein? Seems like many surgeons have a cookie cutter approach and remove scalenes, costoclavicular and subclavius without first trying to understand which specific structures are doing the compressing. It also seems like many surgeons aren't selective and rather than trying to understand patients natural history they just automatically suggest surgery. I hope I can get some more data on myself on my anatomical features, chronicity/acuteness, and thrombophilic states before have a surgeon alter my anatomy forever. This way I can no there was absolutely know other way for me before surgery.

The coughing and background noises make it hard to listen to.. Good info, though..

Hey,I have tos for more than a year and a half and my hands always hurt and recently my arms,shoulder and hands tremor,plus sometimes the color of my hands look weird like not enought blood or nerve damage.What does that mean and what can I do thanks

It took me 10 years to get surgery. I had atrophy within 6 months of symptoms and lost dexterity in my pinky and ring finger. Getting a diagnosis took years. Then my surgeon made me do 3 rounds of botox which my insurance wouldnt cover and fought me which drew things out longer. If i had just gotten my surgey sooner but no took my atrophy seriously i feel like. My pain is greatly reduced but my hand is still lacking dexterity and the atrophy never recovered. Why couldnt they have diagnosed me faster?!

Is it possible that after vTOS decompression surgery the brachial plexus gets shorter? Went through the surgery (rib resection and scalenectomy) and I have continuous increased tension in the plexus on the surgery side. Is this likely scar tissue or entrapments in the shoulder/pectoralis minor? How should this increased tension in plexus (visible in the neck) be treated?

I really hope you get more PCP's, Family practitioners and other various specialists aware of this condition. I've been dealing with NTOS since 2017 roughly. I had my trifecta surgery back in 2022. I'm still really messed up and live and breathe pain everyday. No doctor will touch me, not even for a physical. I can't get any kind of medical help and I don't understand why. The most I've been told is my condition is rare and complex and no one will touch it. I think I might have developed CRPS because my chest gets a burning sensation these days. Sometimes, during a flare up, I will be in so much pain I get dizzy and lose consciousness. Typing and texting hurts, sorry for long paragraph and typos.

Dr Werden, u have a deep knowledge of your expertise. ❤

صح لسانك

I was wondering why I’ve been experiencing intermittent numbness and tingling in my feet and toes. I have bilateral neurogenic TOS.

I would also like to add, that being a hair stylist is highly underrated and not talked about very much. I have had TOS since I was 11. I’ve seen countless doctors and I was a hair stylist for almost 15 years which I believe made my symptoms so much worse. Constant overhead movement while holding tools.

Hi, I have been diagnosed by Dr. Fleischlag in NC with NTOS. I am glad I found your TH-cam. I am set for surgery June 24. I think a helpful video would be a video explaining this to our families who really haven’t done the hours upon hours of research that all of us who have been diagnosed have done. Thank you for what you’re doing.

Have you ever heard of cerebrovascular hyperfusion from arterial tos? I have severe cognition and vision changes that directly correlate with the amount of subclavian artery compression. I also have bruised looking bags under eyes that go down my cheek a bit when compression is bad enough. There is a medical paper called " Does thoracic outlet syndrome cause cerebrovascular hyperperfusion? Diagnostic markers for occult craniovascular congestion" Kjetil Larsen is one of the authors and everything lines up with what I have been experiencing.

Can Snapping Scapula contribute to TOS?

🙂 'promosm'

Wow, this doctor is fantastic. I went to a neurologist amongst others and told him my sports physio said he thought I had TOS. I have been complaining about scapula, chest , neck pain for the past almost 6 years. All he did recently was squeeze my fingers, checked for muscular weakness etc etc.. when this first started almost 6 years ago it wasn’t as bad. I kept asking(neuro) to also check my scapula. My issues are only left sided. I had even circled w/a black magic marker the areas I was talking about. He basically was useless. Dr Newkirk is 100% correct, doctors only see through the lenses of their specialty which is really bad for the suffering patient. Hoping this doctor still is practicing b/c I seriously am thinking of scheduling an appt.

My dr is absolutely against surgery. She says it only makes matters worse. I am confused.😢

what do we do about the leg

Can I get tos from having heart catheter done through the wrist? My arm was stretched out and i felt a massive burning sensation in my shoulder while the procedure was happening. While in the recovery room i noticed what i now know is ulnar neuropathy. Months later i started getting pain throughout my hand, inside of my elbow, my thumb which has numerous issues now other than pain. I get pain in my outer shoulder when using it. Due to insurance not working for me im not able to get proper care to find out whats wrong with me. Do you think tos could be my problem? Thanks for any info you might be able to share

All of these comments are me :(

I know this is old but im hoping you see it. I was born with extra cervical ribs (bilateral). They are very high at the base of my neck. The vascular surgeon said physical therapy wouldn't help but we had to jump through hoops for insurance but ever since my second appointment my heart keeps racing. 120 beats per minute. They want to correct my posture first but when i stand up straight and correctly, it makes my heart race. I haven't had an mri of my back and something in the middle feels disconnected. I feel scared that something is wrong but my doctor nor physical therapist will take it seriously. What do i do?

Good to know. I have a car crash into me from behind, whilst I was stationary. I have a sternoclavicular joint dislocation posterior, a fracture on the clavicle and it dislocated from the AC. I have a smashed first rib it has a osteophyte growing in to the chest. The first rib is separated at the costal vertebra, nerves compressed at T5, 6, 7, 8 roots, T1 as well. That’s just the right hand side. The left sternoclavicular joint has ligament tear and same spread from the nerves. This caused multiple embolic strokes, ignored by the hospital, ignored by the doctors and the pain has been absolutely horrific along with dizziness. The stroke went in the back and hit the frontal lobe so I have problems with my impulse control, it’s getting better. Thanks for this video, I could have presented this video including the neurogenic symptoms. Love the video this is one of the best I have watch. Thanks gents.

Thank you for ALL of your videos on TOS!!! I have learned recently that I have this, and am awaiting a much anticipated appointment with a vascular surgeon. Your education on this condition through your videos is helpful beyond words!! Understanding the anatomy greatly assists in trying not to aggravate things further until I know exactly what I'm up against with this. I get so excited to watch your videos, and just so happened to get to be the first to click the "like" button on this one...oddly satisfying haha! 😂👍

thank you for all your information..I am of the very rare stroke patients. 11 years ago I woke deaf dizzy and listening to a roaring on the affected ear. I will be sharing this video.