So you think I should ask my doc for a cat scan?

Hi! How do I go to you? I live in Loa angles

This was by far the best info I have seen! Thank you! Maybe I missed it, but is there a specific MRI that will show the compression of the Brachial plexus? During shoulder surgery, if a thickened coracoacromial ligament is released can this cause the shoulder to roll forward and end up becoming TOS? Is the pectoralis muscle ever involved with TOS?

What's the best way to schedule a MRI. I have called several times and haven't received a call back. Thanks

My doctor made me wait years to get the surgery and had me go through rounds of Botox my insurance wouldn't pay for and had to be fought for I just can't help but wonder if they had done it sooner you say you don't want to get to that point but they didn't diagnose me for years so what was I supposed to do

This is one of the best and most informative videos I have seen on TOS. Thank you so much for your expertise! I am tempted to fly out to get your care.

Very insightful tysm! What would you suggest? What test? I go tomorrow for my test,😅

These protocols focus on the optimal visualization of the thoracic outlet region, ensuring that all potential areas of compression are thoroughly examined.

MRI provides high-resolution images, allowing doctors to clearly see the detailed structure of the nerves, blood vessels, and skeletal muscles in the thoracic outlet area. 😊😊

Hi what happens if you have Vascular TOS but the left subclavian vein is occluded? Can you still weight lift? What is the best course of action for a normal life

right, but how aboug a bad curve needing surgery real young, and causing a host of issues like nTOS?

Hi, I have Vascular TOS, however my the left subclavian vein is completely patent and I’m currently taking blood thinners. Will I ever be able to weight lift or exercise again and do I need my rib removed? I would appreciate a response

Thank you for creating this video!

I live in France, I am 38 years old, i live in France and I have two jobs, one at the computer and the other in a bakery, but it's similar to what you'd describe as a UPS delivery person's job - carrying boxes and lifting my arms a lot. The first symptom appeared 2 months after I started working at the bakery. I ignored it because I thought it was just a sore wrist, then the pain moved to the elbow on the other side. After 6 months it got drastically worse, until before my sick leave, I left work crying in pain. I couldn't move my arms, and I had tingling, weakness, pricking sensations, arm pain, and numbness in one arm. At first, I was diagnosed with tendinitis, then the physiotherapist with a bilan suspected something else. After an X-ray that showed astrose in my chest, I was seen by 2 family doctors, and the work doctor, I was their first case. I insisted on seeing a specialist and not leaving without a final diagnosis. Since I live in France, I went to a vascular doctor. He did an echo on my arms and saw that blood wasn't circulating in my left arm when it was at a 90° angle. He confirmed the diagnostics. I am currently doing physiotherapy, but my questions are: don't know if is neurogenic, arterial or both and is this a professional disease? Thanks for the content.

I'm so thankful I've discovered Dr. Werden and this little channel dedicated to us patients with this hard-to-diagnose condition. I've had symptoms for 4 years now, been to A LOT of doctors as well (got different diagnoses) but nothing helped. Only Dr. Warden confirmed my suspicion for more than a year now and I've decided to take another chance and go to a specialist in our area - but this time with more information and confidence of advocating for myself. I hope I could go to great specialists like Dr. Werden but I'm all the way from Asia.

Very interesting! I appreciate the information. I was recently diagnosed & treated with a first rib resection for Pagett Schrotter

I really appreciated art jenkins video when he showed tos 2 tos patient cases with pain/parestesia CBSQ diagrams of the patients. Can you share more CBSQ pain patters of patients with TOS? Specially when there are non classical pain/parestesia patters?

Thank you for this. There is very little info out there. I was diagnosed with Paget Schrotter.

I have gotten nerve injury after laparoscopic appendix surgery. The pain is over 10. Thanks for all your efforts and time. I have been diagnosed with TOS, but none of my doctors cares😢

Can’t believe I’m the first to comment. This video is so helpful and deserves a lot more views. Well done doc.

also which is the name of the study about no correlation between adson test and plexus compression?

Can you share the name of the study you talk about in 32:23?

would love to see the cases of patient 3 and the rest that wasn't shown in this video. Any way to see that?

Would love part 3. What about MABC diagnoses tos shown in 7:02.

These videos are dope, i'm watching every single one of them. Doc. Jenkins mentioned the Bertolotti syndrome, I swear... Finding an extra pseudo-rib while pressing on the QL (i was trying to relax it) is really the strangest thing happened in my studio!

👌💘🤙

I appreciate your video

I really love this video ❤

The part when you said that you don't want to stick a needle in the nerve around the spine made me think that we need an other way to stimulate it without a needle... Modern medicine needs to advance more in this field...

I wrote a longer description of my TOS and experiences with it. Sharing our stories always seem to help others get a proper diagnosis! Dr. Werden, I have noticed that when my one of my trapezius muscles get swollen and hard, the knots and pain extend up the neck and into the head causing migraines. Rarely I can use my massage gun to release the muscle and get relief. But 99% of the time I have to take a migraine medication, Imatrex. Why would a migration medication work to relieve this flair up of tightness and mostly pain? Post op I was at a point where at home migraine injections stopped working.

I have Bi-lateral TOS. I have always thought my case would be a good one to add to a study. My surgeon is considered one of the top 5 in the U.S that specialize in this surgery, Dr. Gregory Pearl. I had my left side surgery first and then 8 months later my right side. In the thousands of cases he has done, I had two things he had never seen before. Both of my Anterior Scalene muscles were literally ROCK HARD! Dr. Pearl noted that he had never seen one let alone both anterior scalene muscles as hard as a rock. The second thing he had not seen until my case. Was the large fibrous bands that filled my pectoral or chest area. He removed all of the banded tissue. He as well removed both first ribs along with the connected anterior scalene muscles. My TOS is three fold in that it is genetic, as my Mom has right sided TOS. She had a rib resection done in the early 90s.This is when they only removed a small section of the first rib. Her chronic pain was only alleviated by a smaller percentage than is possible today, with full rib removal. Second I suffered from 4 or 5 events of severe whiplash. 3 were car accidents and 2 other more severe neck injury. Third I was a hairstylist for 17 years, until my TOS caused me to be disabled as it went undiagnosed for so long. I also have the unfortunate, rolled forward shoulders, forward set head, and that posture. What I find odd is that genetically my Mom has diagnosed right sides TOS. But my Father has the very obvious rolled forward shoulders and forward set head. Massage therapists were always shocked and confused when my shoulders would be so high up, “around my ears,” they would describe. And then they would both drop a few inches after the massage. I have not been able to meet and receive care from a Primary Care Doctor in the Houston TX area. I have had to retain my Primary Doctor in Seattle while I live in Texas due to each doctor denying to take me on as a patient. They each said they had never met anyone with TOS, had only read about it in text books, or had never heard of it before. Even the pharmacists here don’t believe in this “rare” disorder causing the kind of level 10 chronic pain that we suffer.

Are you accepting new patients and if not, do you do over the phone/video consults from someone in another state?? Thank you

little awesome video. Thanks sir

Thanks doctor. Wait for your next video ❤❤

So nice and very informative music video. Thanks for this video

I appreciate you ☺️

Very helpful video ❤

Great content ! thanks

Search time spend here

You did great job 🥰

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This is extremely informative. Thank you for putting the infos out. I have been (unfortunately) suffering from all 3 types of TOS since 2006, they used to just laughed at me. It’s all in my head. I believe mine has something to do with LTN damaged post shoulder/labrum arthroscopy. I also have (L) scapular winged, nearly all procedures, injections, scalene ectomy, 1st rib resection, pectoralis minor surgery & other modalities have intermittently helped and today I visited again as it’s insanely inflamed (.1/25/24). 😂 I hope every one suffering will heal or get some kind of relief. I’m based in Los Angeles and I can vouch for 3 excellent physicians and a Nurse anesthesiologist. Bless you all.

Thank you for what you do doctor!

What were all of the symptoms???

What can I do to calm my nervous system down if my body cannot currently tolerate exercise to correct the NTOS (posture)? I had recently sent a message to consult with Dr. Werden but was told that I am unable to consult with him directly due to being in another state. I am having a very hard time getting help with this and I have really bad muscle wasting in both arms / hands. I can barely write / type and don't have any personal help in my life. Any advice would be highly appreciated.

Is surgery generally the path way for TOS patients with muscle atrophy? I've had hand wasting for a number of months now, PT has drastically increased by mobility and strength. However wasting is still present, will wasting generally clear after time or is surgery required?

Have you ever seen anyone who has had even part of their hand muscles come back? I have significant wasting in both hands which is a huge concern and very limiting.

I have bilateral Cervical ribs. I had thoracic outlet surgery about 6 months ago now, it was neurogenic TOS with mild compression of the subclavian artery. The surgeons left the Cervical rib in and resected a section of the first rib. They said the Cervical rib was not compressing anything, but since then I've had second opinions from numerous surgeons who said leaving the C-Rib was a mistake. In your experience is it necessary to always remove the Cervical rib to achieve optimal results?

close to two dozen or so, a ton of diff specialties. it was a wild ride to say the least.

Many thanks for this highly detailed explanation of TOS. I have had pins and needles in my ring and pinky fingers and occasionally my other three fingers. I have it both sides but worse on my left. It keeps me awake almost every night. I had a nerve test and the doctor diagnosed carpal tunnel and I was offered surgery. This does not make sense to me since my main symptoms in my ring and pinky fingers relate to the ulnar nerve. After studying TOS for a week of so I now strongly suspect TOS is my problem. I have been following exercises relating to TOS and have seen much improvement over the past week or so. I am so grateful for videos such as this and many others for helping us look after ourselves and make the right choices.