I am an orthopedic surgeon specialising in the management of shoulder problems both non-operatively as well as surgically – always endeavouring to minimise the intervention and making it is as effective as possible. I am passionate about disseminating information to empower sufferers to make the most informed decisions about their treatment. That is achieved by our website and this blog.
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The exercises described for TOS are very effective when performed regularly, and are very helpful in alleviating pain and/or tension in that area. The information is clear and concise. I have personally benefited from doing these exercises and have consequently referred a number of people to your website.
Thank you for the comment Susie,
It is worthwille to have a good conservative method of treatment available for this difficult problem of TOS. I may mention at this time that another treatment option lately is to inject Botox into the scalene muscles. As we know Botox (Botulinum) causes temporary muscle paralyis and by having that effect on the scalene muscles the pressure on the nerves of the brachial plexus in the thoracic outllet is relieved and therefore the nerve pain is diminished
Dear Dr. de Beer, Thank you for the information – that’s very interesting – it must take quite a large amount of botox to have an effect in this area? How long would the effects last for? And would any side-effects experienced on the range of motion/movement?
Dear Dr. de Beer, Thank you for the information – that’s very interesting – it must take quite a large amount of botox to have an effect in this area? How long would the effects last for? And would any side-effects be experienced with regards to the range of motion/movement?
A large amount of Botox is not required -under ultrasound guidance the Botox is injected into the muscle bellies of the scalenus anterior and scalenus medius muscles ( the nerves of the brachial plexus pass between these two muscles) By relaxing these muscles the pressure effect is then diminished. The effect of Botox usually lasts for 2- 3 months but if used a few times the duration may be longer. There is no effect on the range of motion of the shoulder as it is not injected near the shoulder joint at all
Thanks a lot for the info and your effort Dr.!
Dear Hanjoret,
It is most gratifying to receive your comment and makes the efforts worthwile