[swampthing]

Pretty sure I have TOS too — it's how I came to discover Kinesis keyboards. It's manageable for me now, but I would be curious to find out if there was nerve damage so that I know how further I can improve and what's futile. Can I ask how the doctors determined that there was damage to your arm nerves? E.g. what sort of imaging / tests do they do?

[yabatopia]

In my case, the first clue came by accident. The MD asked my to hold my arms up and after a short time it became really painful and intolerable. Another one rest is taking your pulse by hand while holding up your the arm. If the pulse is pretty weak, hard to feel or completely disappears, that’s a strong indication for TOS.

An electromyography or EMG is also often used to determine neuromuscular problems or nerve damage.

A MRI scan can also reveal TOS problems, but the medical technicians must be familiar with it the tests and and execute them correctly. In my case the MRI scan was negative, probably because the test was only partially done (in hindsight).

For me, the real confirmation came after an extensive arterial duplex ultrasound examination at a university hospital. Various head rotations, arm and shoulder positions were examined. In some positions the arterial flow in my arm completely disappeared. The examining specialist physician, a professor of medicine and specialised in TOS, called it one of the most clear cut cases of TOS he has ever seen in his career.

Based on the MRI scan there were some serious doubts that TOS was the problem, bus the ultrasound tests made it perfectly clear. It’s shows that it is really important that you consult doctors or surgeons very familiar with Thoracic Outlet Syndrome. Search on the internet for recommendations or specialised medical departments.

Best of luck!

[swampthing]

Thanks — I appreciate all the info and advice! This is invaluable.