TOS - C8 - extreme pain!

by Elle
(Canada)


TOS - C8 - extreme pain!

Years ago, I was diagnosed with TOS contributed by 3 car accidents from behind and whiplash.

Over the years I have had numbness in my fingers, pain in my elbow, neck pain, shoulder pain and lower back pain - all on my left side (pain in my upper chest as well).

I can't turn my head, touch my ear to my shoulder, left or right side or tilt my head backwards.

I have pain in my jaw as well (I do have TMJ on left side so perhaps this pain just irritates it).

The amount of pain I was in a month ago took me to hospital for pain medication and an xray. The xray showed no bone spurs but the doctor feels that I have issues within C8.

This time, I hadn't been thinking and picked up a heavy bag with my left hand and felt a "tearing sensation" up my arm and then directly into my neck, down my shoulder and straight to lower back, my leg is also paining right now and my foot is numb. Could this really be pinched nerve(s)?

Hello Elle,
There are three separate, but perhaps interconnected things going on here.

Firstly, what's needed is to be sure that you have TOS and not a pinched C8 nerve root. Both produce pain running down the arm, both to the little finger.

But in TOS the arm pain and tingling in the fingers is increased by raising your arm as in hanging the washing. Both the artery and the nerves are affected.

Whereas, with a pinched nerve root, placing your hand on your head RELIEVES the pain. The so-called Shoulder Abduction Relief sign.

And in a pinched nerve root, the Upper Limb Tension Test will be very positive. Try this test at home.

So, which sounds more familiar?

The definitive test for TOS is the Adsons test but it's a difficult test to do objectively. Unless your doctor / chiropractor has done the test many times it's very difficult to be sure whether it's positive or not. Lots of false positives. Positive test in quite normal people.

In the presence of a positive Shoulder Abduction Relief, negative Adsons test and pain running down the arm when you turn your head to the left and simultaneously look up, I would recommend an MRI to be sure there's no disc prolapse.

Opposition of the thumb and little finger will often be weak. Or the triceps muscle depending on the nerve.

If you prick your arms with a pin, any sensory difference, right and left?

The jaw joint pain is probably unrelated, though it often causes UPPER neck pain and very severe facial pain and/or migraine headaches. TMJ anatomy ... try poking your finger into the pteryggoid pocket and seeing if the lateral pteryggoid muscle is EXTREMELY tender.


You can do the Slump test for sciatica at home. Try it.

These are all conditions that face the chiropractor every day, Elle, but none are easy and whilst I now treat them all fairly confidently, for the first 10-15 years that were often a nightmare.

So don't feel alone. You are hurting. Talk to friends and fam and your doctor and get the name of an experienced thorough chiro in your neck of the woods.

Good luck, let us know in a month or two how you are getting on. Get back to me if you want clarification;

Perhaps print this out and take to your chiro for discussion purposes.

Find a good chiropractor may be your next step.

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Dr B

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