**
1. since
thoracic outlet syndrome is caused by compression of the
brachial plexus or subclavian
artery and/or vein in the region near the thoracic outlet thus
general Surgeon will be in a better position to explain you the prognosis with relevant examination and investigations.
2.
.pain could be due to
ulnar nerve occlusion
. pain,
numbness, weakness is symptom of arterial occlusion
3. Blood: routine examination of blood, sugar [for diabetes], lipid [for cholesterol], urea and electrolytes will give a clue to the diagnosis.
. Straight X- ray: for arterial calcificaitons
. Arteriography: is the most reliable method of determining the size of the main arterial tree.
4. Diabetic amyopathy although occurs in lower limb, however, when symptoms involve the shoulder girdle, it must be considered in the differential diagnosis of shoulder painful conditions [because it is a Predisposing factor].
5. successful and result oriented prescription in Ayurveda is
. Initially dry heat
. giving dashmool decoction with ghee after meals [through nose]
I. Vatakulantak ras, panchamrit lauha guggulu, rason sura, rasraj ras, dashmoola arishta, erand pak.
II. Karpasadi tail, maha narayan tail, narayan tail, for external application [massag
PS. since knowing our limitations, Management has been provided from my side, but it is better to remain under regular guidance of a surgeon for future prognosis