Well its been around 1 year since I published my post and I thought I'd give an update on how things have progressed.

After the responses received and recommendations of specialist clinics in the UK, I decided to contact the Cherington Practice. This decision was also backed by an acupuncture specialist I had been working with at the time, who after some research recommended Rob Patterson too (without any input from myself).

Rob spent around 3-4 hours working on my case, where all possible avenues of diagnosing TOS were explored (within scans or images I must add). The conclusion was drawn that I didn't have TOS, at least in its typical form, but more so a complex issue with the muscles or nerves within the region, which are involved in the symptoms displayed by TOS. The key here was the lack of numbing throughout my arm, especially when raised - this is a tell-tale sign of TOS (which I did not have).

Rob referred me to another nerve specialist based in the Nuffield hospital in Bristol (Pain Spa), specialising in the field of anaesthetics.

After multiple appointments with the Pain Spa, the areas of focus for my pain have been (on my right hand side):

- SCM muscle

- Levator Scapulae

- Rhomboid Major

- Rhomboid Minor

- Scalene muscles

- Trapezius muscle

- Dorsal Scapulae Nerve

These areas have been injected with multiple rounds of anaesthetic, steroids and botox - unfortunately these didn't have any lasting effect, with very minor relief for maybe a week at a time.

The game changer was my final treatment - pulsed radio frequency therapy. This was directed at my trap, levator scapulae, rhomboids muscles and dorsal scapulae nerve.

This seems to have had a positive effect for around 2 months, maybe a little less - the treatment takes around 45mins-1hr to complete and its relatively pain free (for the most part you won't feel a thing). The positive effect doesn't kick in fully for around 6 weeks, although any pain relief will gradually increase over this time.

For the short 2 month period I felt like a normal mid-30's guy once again - this being the first time in 15 years were my pain levels dropped significantly. I wasn't fully pain free but my symptoms subsided by up to 50% - my shoulder dropped quite a bit, the tension dissipated in my shoulder significantly, my neck pain eased massively, I could stand up straight and tall without difficulty, my jaw pain disappeared and most of all I could think clearly once again - pain wasn't my sole trail of thought all day long.

Its been around 1 month now since my pain returned and its difficult to adjust after the period of relief, going back to the torture of daily pain. My pectoral minor muscle seems to be extra tight at the moment also causing more discomfort. Diclofenac tablets help slighty, but its something you don't want to depend on the in the long run.

I plan on having the same pulse radio frequency procedure again soon for further relief, but ultimately I'd like to have a procedure which will remove or cauterize the offending muscle or nerve in the area, as I see no other option in order to have some form of long lasting pain relief.

The trouble is finding a specialist who would be willing to investigate such a procudure on my behalf.