Guest guest Posted December 16, 2003 Report Share Posted December 16, 2003 Let's take things from the top. We have already had some pretty detailed discussions on what TOS is. Again citing Rattray, here is the definition of the Brachial Plexus itself. The general anatomical area is the neck and shoulder. " This network of nerves extends from the neck to the axilla. The first structural segment of the plexus is the organization of nerves roots from C5 to T1 into trunks. Roots from C3-C6 for the superior trunk. C7 makes up the middle trunk, and C8-T1 the inferior trunk. Each trunk then splits into an anterior and a posterior division. In general, nerves originating from anterior divisions supply motor, sensory, and autonomic function to the anterior parts of the arm, while those from the posterior division supply the posterior arm. The second structural segment organizes the trunk divisions into cords. All three posterior divisions form the posterior cord. The anterior divisions of the superior and middle trunks make up the lateral cord. And finally, the anterior division of the inferior trunk forms the medial cord. It is from these cords that the individual nerves branch off. These terminal branches include the radial, ulnar, median, musculocutaneous and axillary nerves. " Rotator Cuff is an entirely separate issue/condition. The Rotator Cuff is comprised of the tendons of four muscles: Supraspinatus, Infraspinatus, Teres Minor and Subscapularis. The Supraspinatus muscle lies along the top of the Scapula in back. The Infraspinatus covers the body of the scapula in back. The Subscapularis covers the entire underside of the scapula. The Teres Minor attaches along the lateral (outside), bottom edge of the scapula. All of them attach on their other ends to spots on the humerous (arm bone). These are the muscles that allow you to move your arm up, down, back, etc. The " cuff " is the area at the point of the shoulder where they attach to the humerus. A Rotator Cuff injury involves a sprain, strain or tear of one or more of these tendons. It is certainly more than possible for someone to be suffering from both Rotator Cuff problems and TOS at the same time since they are two different conditions. As for the Brachial Plexus " something " there is more than one possibility and I couldn't even begin to guess from here as to which he might have been referring. An excellent book covering shoulder pain in general is simply called " Shoulder Pain " by Rene Cailliet. He is an M.D. and has a series of nine books on pain (shoulder, knee, hand, low back, face and neck, general pain, etc.) He is one of the authors I trust. (And I do have the full set in my reference library.) At any rate, here is what it says: " A condition that has been called brachial plexus neuropathy has also been termed localized neuritis of the shoulder, acute brachial radiculitis, localized nontraumatic neuropathy, acute shoulder neuritis, serum neuritis, paralytic brachial neuritis, and neuralgic amyotrophy. These terms have evolved in contraindication to mechanical TOS, in that they have been determined to be inflammatory and/or infectious in their origin. The initial presenting symptom is shoulder pain with ultimate weakness of specific muscles of the involved plexus innervation. Clinically there is a rapid onset of severe pain, usually followed by weakness and paresis. The latter often occurs within 2 weeks of the onset of pain. The pain is usually intense and is described as sharp, stabbing, throbbing, or deep aching. Usually there is also an associated muscle soreness. Pain occurs predominately in the upper plexus and is rarely noted below the elbow. Currently this is considered to be a neuropathy associated with a systemic infectious disorder, or it is an allergic hypesensitivity reaction to a systemic disease process. This syndrome occassionaly occurs after administration of a foreign serum, such as a vaccine. " Note the distinction he is making between " mechanical " TOS and " systemic " TOS/shoulder pain. In either case, one of the treatment protocols I would highly recommend is Lymphatic Drainage Therapy. It is very gentle and non-invasive. But it also does wonders for reducing edema (swelling) as well as inflammation and felt pain. It is an absolutely super modality. I have even been known to use it to finish a session if I have been doing particularly deep/aggressive Swedish techniques. It helps reduce any after session soreness. > On my recent workers compensation doctors update/check up visits for > my right shoulder (which has RSD and is very unstable and has been > repaired surgically with complications etc (I can give you more info > if needed)(what a waste of time, see a strange doc for about 2 > minutes who has can decide your future etc). > What I am asking is the DAFT OLD OS I saw said I had a Brachial > Plexus " somthing or other " I can't remember what the soemthing was > though. He basically said I had a rotator cuff injury, Thoracic > Outlet Syndrome and a brachial plexus " something " ... > I was just wondering if you would have ANY idea of what the brachial > plexis thing could be??? my past record state I have a STRONG > brachial plexus sign, but I am NOT sure what this means (I know it is > to do with where the nerves run through from the chest down the arm > etc). The FIRST thing out of this doctors mouth was RSD does NOT > exist, there is NO such thing (which put me is SUCH a great mood etc) > I had flown down to do this appointment (well I saw 2 of there doc's, > was supposed to see 3 but I missed my flight (and that is a WHOLE > nother story). I DID NOT tell these guys that I have EDS. > The psycologist I saw could NOT work out why I had been sent to see > him as he said " there is NOTHING wrong with your mind, it is your > body that is stuffed " . he went on to say that his reports will have > to state that I can work from his point of view as my mind is fine, > there is no depression or anxiety disorders etc and that I seem to > have adjusted very well to my changed life and injury. > Anyway I was wondering if you would have ANY idea of what this > Brachial Plexus thing would be??? > Thanx in advance > Sharon Quote Link to comment Share on other sites More sharing options...
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