@kellynormand I am a Mayo cervical spine surgery patient, and I also have thoracic outlet syndrome. My surgeon is a neurosugeon and also with orthopedic spine fellowship training and is one of Mayos' best.

The pain in your upper chest and pec muscle is a common symptom of TOS and I have had that. TOS is more common in spine patients and a lot of doctors miss it. Usually physical therapy doesn't help TOS, unless the PT knows how to do myofascial release work to stretch the tight fascia that is compressing nerves and vessels as they pass through tight spaces and spasms make this worse. It sounds like you have stenosis at your nerve roots with bone spurs there. I had spinal cord compression with bone spurs and a ruptured C5/C6 disc and had the TOS complications at the same time. I had decompression surgery at Mayo and I am still in physical therapy for TOS which is improving. The surgery made it worse for awhile because of a surgical scar path through the fascia near the problem of entrapment from TOS. It's like wearing a straight jacket.

If you can come to Mayo, they are good at diagnosing TOS. Your symptoms could be more from TOS than the spine at this time. A neurologist can help figure that out. If you can come to Mayo for that, I would recommend it. Let me know if you have more questions. I would investigate TOS as a possibility, if yes, get a good PT and do myofascial work to see of you improve, and work with a spine surgeon who understands both of these issues (like mine if you are able to come to Rochester). He wouldn't jump in just to do surgery, and you would get an honest evaluation. If you look at your imaging, look for the fluid space around your spinal cord. With stenosis in the central canal, if you see no space (white space) around the cord, it will get compressed. That was my situation. If you do still have space where your cord can move with your body position, it is not as bad. If you do need spine surgery, and if you have done a lot of MFR work, it will give you an easier surgery because tissue will be more mobile. Here's my story https://sharing.mayoclinic.org/2019/01/09/using-the-art-of-medicine-to-overcome-fear-of-surgery/

TOS causes tingling in the pinky from the ulnar nerve. It is a compression in the chest between the collar bone and ribs, or from tight scalene muscles in the neck, and there is a compression point under pectoralis minor in the chest. My PT does myofascial release work to stretch the front of my chest and neck, and exercise to strengthen the back and muscles around the shoulder blades. TOS is a positional problem. When you read or type, your head is likely forward and shoulders moved forward which puts pressure on the compression points. Sleeping does this too because of raised arm positions. One test for this is the doctor raises your arm in a bent arm position and checks for your pulse to stop, and also when turning your head. A lot of doctors miss this and don't understand TOS because it's glossed over in med school (per my neurologist). Specialists in TOS are usually at university teaching med centers that treat it (check on website for conditions treated). If you have more questions, I'd be happy to answer.

Here is some information for you about TOS and MFR.

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988
https://trainingandrehabilitation.com/how-truly-treat-thoracic-outlet-syndrome/

Directory search for MFR therapists on myofascialrelease.com
https://www.mfrtherapists.com/app/interim.asp

Problems that MFR helps
https://myofascialrelease.com/about/problems-mfr-helps.aspx

Use Fascia as a Lever John Barnes
https://myofascialrelease.com/downloads/articles/FasciaAsALever.pdf

Lumbo Sacral Decompression video with John Barnes
https://www.youtube.com/watch?v=g9v7hzr_IqE

Therapeutic Insight: The John F. Barnes' Myofascial Release Perspective—Rufus, the Cat
https://www.massagemag.com/therapeutic-insight-the-john-f-barnes-myofascial-release-perspectiverufus-the-cat-12559/

There's the Rub
https://myofascialrelease.com/downloads/articles/TheresTheRub.pdf
Therapeutic Insight: The Myofascial Release Perspective—Myofascial/Osseous Release
https://www.massagemag.com/therapeutic-insight-the-myofascial-release-perspective-myofascialosseous-release-7597/

Therapeutic Insight Articles
https://myofascialrelease.com/resources/therapeutic-insight.aspx

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