Thoracic Outlet Syndrome can have many causes
By Scott Finley D.C. - Chiropractic Physician
The thoracic outlet is a small space between the collarbone (clavicle) and the first rib. Thoracic outlet syndrome (TOS) is a group of disorders that involve compression, injury or irritation of the nerves, or blood vessels in the thoracic outlet. This can cause pain in the shoulders and neck and numbness in the fingers.
What are the causes?
The cause of the compression can vary and may include:
•Anatomical defects: Inherited defects present at birth, including a cervical rib-an extra rib located above the first rib-or an abnormally tight fibrous band connecting the spine to the rib.
•Poor posture: Drooping the shoulders or holding the head in a forward position can cause compression in the thoracic outlet area.
•Trauma: A traumatic event, such as a car accident, can cause internal changes that then compress the nerves in the thoracic outlet area.
•Repetitive activity: Doing the same activity over and over can wear on the body’s tissues. You may notice symptoms of TOS if your job requires continuous repetition. Like typing, working on an assembly line, or stocking shelves.
What are the symptoms?
The symptoms of thoracic outlet syndrome-as well as their intensity- vary between individuals and depend on the location of the compression site.
When nerves are compressed, signs and symptoms often include:
•Numbness or tingling in the neck, shoulders, arms or fingers
•An ache in the arm or hand
•Weakening grip
•Difficulty with fine motor task.
Compression of one or more veins and arteries can result in symptoms such as:
•Bluish discoloration of the hand
•Swelling or puffiness in the arm or fingers
•Coldness of hands or fingers
•Throbbing lump near the collar bone
•Deep pain in the neck and shoulder
•Arms and hands that easily fatigue
How is it diagnosed?
Because TOS does not have unique symptoms, it can be difficult to diagnose. It is important to differentiate TOS from other conditions like carpal tunnel syndrome, shoulder syndromes and herniated cervical disc(s).
A detailed history and examination are the most important components in establishing a proper diagnosis.
Your doctor of chiropractic may also recommend x-rays, MRI ,lab tests or a nerve conduction test.
How is it treated?
In the majority of cases, a conservative, non-surgical approach to treatment is most effective, especially when the condition is diagnosed early. A chiropractic treatment plan for TOS may include a mix of joint manipulation, physiotherapy modalities, soft tissue work, nutritional products, homeopathic remedies and a home stretching/strengthening program.
Patients should avoid prolonged positions that cause then to hold their arms out or overhead. For example, avoid sleeping with your arm extended up behind your head.
Weight reduction can be helpful for obese patients.
A home exercise program can be a very helpful tool. Always consult with your chiropractor before you start a new program. They can develop an individualized program for you.
Questions and comments can be addressed to Dr. Finley at Finley Chiropractic 419 Main Street Stevensville, Mt. 59870 or through his website www.finleychiropractic.com
Reader's Comments >>