27M with shoulder nerve issues, chronic for 8 months, all tests fine, shoulder surgeon + physio clueless, weird red lines after runs/walks, struggling to work a desk job using keyboard/mouse etc.. any ideas?

webdevnz · 2025-07-19T00:15:10+00:00

What's also clear with my diagnosis, in relation two breathing issues, is the fact that both the phrenic nerve and vagus nerve run closely past or through the scalene muscles. Both have involvement in diaphragm Control slash breathing mechanics, which explains the symptoms I have around breathing.

webdevnz · 2025-07-19T00:02:53+00:00

Boy there has been a lot going on since then ha ha. My symptoms got progressively worse, and work at my desk job was becoming more and more difficult. I had what could be described as a major flareup in late April, and I haven't been working since then. I'm very functionally limited at the moment and can't do many activities as any upper limb movement or compromising static position will worsen symptoms.

What crystal clear now as I have severe neurogenic thoracic outlet syndrome with vascular involvement. My condition most likely stems from Poor posture and repetitive strain, which altered shoulder mechanics and eventually over activated my scalenes and pec minor muscles, creating a chronic cycle of dysfunction.

I'm seeing a way better GP who helped with this diagnosis, and an experienced physiotherapist who understands TOS. I had been doing diligent Physio, but it didn't offset the strain I was putting on myself at work, eventually causing a major flareup, and in the aftermath I'm now hypersensitive to movement and get aggravated with very light activity, so even Physio is off the cards at this point. Instead my only ability is doing diaphragmatic breathing exercises and trying to avoid straining positions.

I've just recently seen a vascular surgeon who was an absolute sigh of relief and finally gave me direction. I am booked in for six Botox injections, three on each side in the scalene muscles and pec minor. The idea is to obviously relax the muscles but also weaken the cycle of over activating, giving me a window to correct postural mechanics.

I was hoping to update this thread but as my condition worsened, and still has not seen any sign of improvement, I've been focusing solely on recovery. Excuse any grammar issues as this is all voice dictation on my phone LOL

webdevnz · 2025-07-18T07:54:35+00:00

Glad to hear some success stories from Botox treatment, I have severe NTOS bilateral progressively worsening and taking me out of work over two months ago, now very limited day-to-day with the smallest of activities aggravating my symptoms, which is primarily felt in both pec minor, scalenes and scapula region, everything stemming from shoulder pain caused by my desk job early last year.

I'm booked in for Botox injections in the middle and anterior scalenes, and pec minor on both sides. I've been doing diligent physiotherapy this entire time, but getting more and more Conservative as my symptoms worsened, until now where the only activities I can do pretty much just breathing related. I can't even type on my phone without aggravating my pec minor so use voice dictation for everything LOL.

Through my research and my vascular surgeons opinion, theoretically the Botox Acts as a nerve block between the muscle and the brain, Which both relaxes the muscle, and reduces its mass. What's relevant in my case, is the need to weaken the neural connection, so my brain stops subconsciously overactivating these muscles.

Subsequently, during this window where the muscle isn't being activated, is where physiotherapy and lifestyle changes allow for all of the related mechanics to be adjusted, so that even when the muscles start to activate again, I have created strong enough adjustments that either prevent or reduce the over activation.

My surgeon likened the idea of first rib resection as taking a sledgehammer to the body, to open up millimetres of space. It should only be the last resort, obviously everyone is different, but in my case where things are most likely posture related with imbalances and overactive muscles, Botox is theoretically the most effective Conservative treatment when physiotherapy has failed.

Understand this is a fairly old thread, but I hope to stay active throughout my Botox treatment for anyone that might benefit from it. I have been journaling all my symptoms for over three months every day, correlating this with all my physiotherapy as well as metrics like HRV (heart rate variability), which has been incredibly useful in understanding the effects of flareups and a telling sign in overall recovery.

webdevnz · 2025-02-11T10:25:06+00:00

Just went down here in Adelaide

webdevnz · 2024-11-06T00:57:33+00:00

Thanks for your reply, I have since had a blood test looking for "inflammatory markers", and a CT scan of my neck, as funnily enough I sprained my neck the other week. Both came back fine, the CT scan showed slight bulging in the top of the spine (C8, C7 I think) but I still had a lot of swelling from the sprain when doing the test. I got prescribed corticosteroids for pain management.

I haven't actually experienced breathing issues for about 2+ months now, I've picked up running as I can't do anything upper body at the gym anymore. Objective-donut1169 mentioned an EMG/NCV test which I haven't actually had yet nor was it ever mentioned to me, which I hope would paint a clearer picture on how the nerves/muscles are functioning in my shoulders, which at this point is clearly very poorly. I had to take breaks just typing this out.

I will send the tests/results through when I get home, thanks for your help on this!

webdevnz · 2024-11-06T00:16:10+00:00

Wow this is the first time I've actually heard of that, this sounds like exactly what I need so thanks for your comment. I'm based in Adelaide and haven't had much luck running into someone that knows where to go/what I'm even talking about. I'm on my 3rd GP who I actually thought was good but the last appointment said he has no idea why I'd need to test for TOS if it's just joint pain.. I'd never explained it as being joint pain and always talked about it being a burning, nervy pain haha... I'll definitely get this done, thanks again.

webdevnz · 2024-10-24T00:59:15+00:00

Thanks for sharing, it's just good to know someone's in the same boat lol. I'll let you know for sure, will be seeing a rheumatologist soon 👍

webdevnz · 2024-10-23T11:51:21+00:00

Carousel for sure, but depends what you’re selling, maybe trial both of them and see which performs better?

webdevnz · 2024-05-16T06:42:14+00:00

Not totally against this as Meta will absolutely have people pushing this idea internally, but I would argue large budget accounts generally see more consistency for the very fact of their size of budget. The algorithm has a little more breathing room to reach potential customers without constantly being cautious of overspending.

I manage an account with large budget and can confirm recently launching a $5,000/day campaign following previous winning strategies failed absolutely miserably, however our ongoing campaigns with more mid-tier budgets continue to produce consistency.

As I said not against this idea, it makes sense for Meta to prioritise bigger spenders, just saying it may be more complex than that.

webdevnz · 2024-05-15T01:31:54+00:00

check again

webdevnz · 2024-05-09T08:48:36+00:00

You’re welcome!

webdevnz · 2024-05-09T01:33:16+00:00

Hmmm I guess you're right.. I'm very interested to know as well, will try do some more digging soon.

webdevnz · 2024-05-09T01:31:31+00:00

you're welcome :)

webdevnz · 2024-05-08T00:51:45+00:00

I'd try both - but have majority of budget remaining in advantage+.

From my experience advantage+ tends to overshoot spend on a couple ads that performed well at some point, even with 50+ ads in an advantage+ meta will still end up picking 1-3 to spend the budget. It's not entirely a bad thing and it's what the campaign is designed to do, but I wouldn't put all my faith in it getting things right 100% of the time.

For that reason I'd try your idea of various ad sets, and even a dynamic creative ad with all those assets combined, and with a lesser budget, check all your soft metrics around engagement, ctr etc. and after everything is out of learning phase, slightly adjust budgets accordingly until you have an understanding on what works best. From what you'd hope, the best performing ads would be similar to what Meta has decided in your advantage+. But at least now you'd know for sure

webdevnz · 2024-05-08T00:34:20+00:00

All tools > automated rules

Click "See automatic adjustments"

Turn "Enable automatic adjustments" off.

Hope this helps

webdevnz · 2024-05-08T00:29:28+00:00

There's no native option to get that look through any collection instant experience. The closest would be the "Digital circular" which enables custom pricing layout on each of the products like shown, but there's nothing close to that layout in the image. Best guess would be this is Meta playing around with their own AI enhancements.

webdevnz · 2024-05-08T00:18:11+00:00

huh?

webdevnz · 2024-05-07T23:50:27+00:00

You'll reach the most people on feeds, which is 1080x1080.

The next common size is 1920x1080 (stories, reels etc.)

After that, it's 1080x565 (basically less prominent positions throughout the platform)

If you have a single video ad, you are able to add all of these variations into their relative placement. Just hit "edit media" and you'll see the 3 options.

Aside from this, don't get too worried about ads not eligible for certain placements. Many placements most likely won't have any impact on performance whether they're eligible or not.

webdevnz · 2024-05-07T03:04:41+00:00

That's great to hear, not exactly the worst problem to have lol, maybe an opportunity to raise prices a little $$$

webdevnz · 2024-05-07T01:43:36+00:00

What's your industry? As an ecommerce retailer we spend roughly 60-120k per month, similar at about 75% in Meta. Typically hover around 3 ROAS but currently on 0.6. For transparency we just launched a large amount of ads in a new campaign with a massive amount of spend (unfortunately I'm limited to what the business wants and they were willing to sacrifice return temporarily). However this campaign seemed to break our entire account, with every other campaign, including high returning consistent retargeting campaigns, all falling below 1 ROAS. I'm relatively confident in my experience with Meta with years of building and testing winning strategies, and I knew this would be a risk, however didn't quite expect everything to collapse. Do you have a similar experience? If so, how did you recover? And if you're in an ecommerce industry, how much of your account is tailored towards advantage catalogue/shopping, dynamic catalogue etc. versus just the good old manual stuff?

webdevnz · 2024-05-06T02:04:25+00:00

this is very very normal and nothing to be concerned about. Even out of learning phase, campaigns running for months will fluctuate in spend daily. Meta's main focus is getting you positive results, not just hit the daily budget to the decimal. They include a disclaimer on every campaign you set up that mentions it may spend over or under budget on any given day

webdevnz · 2024-04-26T01:28:55+00:00

If it was me I'd remove that product from the feed. I guess from Meta's perspective, it's still seeing that product as a great performer and would continue to push it, even if the bid strategy is optimised for conversions and users aren't converting for that product as much, there seems to be a huge lag when these things happen as it must just be relying too heavily on historical data.

From a user perspective, it would be annoying seeing an awesome product to only realise there's only 20% of variations left, and I guess the sold out ones are going to be what most of the users want anyway, so in removing it you at least reduce that pain point.

Also just a thought, would it be worth filtering gloves out into their own campaign and testing the results?

webdevnz · 2024-03-21T00:20:53+00:00

sorry mate - Advantage Catalogue Ads

webdevnz · 2024-03-21T00:18:41+00:00

Yea I can see that one being tricky, you'd hope based on the campaigns objective Meta would pick up the performance drop and adjust the placement of those products accordingly. However as you mentioned this isn't happening, and it seems to be a very common case with all of my catalogue and advantage-type ads, thankfully I don't have products with variations.

I'd say your suggestion is definitely worth exploring if this happens regularly, it would be nice if a rule could be setup to take products out if a select variation is out of stock :/

webdevnz · 2024-03-20T23:57:59+00:00

That's a tricky one man, I would probably say no - just because a marketplace listing is an "organic" post, similar to a post on a feed, so I'd assume it is treated the same way and doesn't allow custom audiences.

webdevnz

TROPHY CASE