Thoracic Outlet Syndrome (TOS) refers to a group of conditions that often cause neck, upper back pain and shoulder pain. TOS causes pain that feels deep within the shoulder and is often coupled with weakness and numbness into the arm and hand. In most cases, only one side of the body is affected. Chiropractic care could help individuals deal with this pain.

What is Thoracic Outlet Syndrome?

TOS is caused by a compression of the blood vessels or nerves, or both, as they pass through the Thoracic Outlet Space which is located in the shoulder region. The space is bordered by our collarbone, 1st rib, and the scalenes muscle in the front of the neck.

Thoracic Outlet Syndrome can be caused by various factors:

• Traumas including motor vehicle accidents, whiplash type injuries, and sports injuries.
• Poor postural habits and rolled shoulders
• Stress and muscular tension
• Excessive overhead arm and shoulder movements
• Anatomical abnormalities (e.g., extra cervical ribs)
• Repetitive motions or occupational factors

In most instances, TOS develops progressively over time due to a combination of these factors.

Types of Thoracic Outlet Syndrome

TOS is categorized based on what structure in the neck is being compressed:

Vascular TOS: Refers to compression of the blood vessels and often causes a cold and pale hand on the affected side due to restricted blood circulation.

Neurological TOS: Refers to compression of the nerves and accounts for more than 90% of cases. The brachial plexus, a bundle of nerves that branch away from the spine in the neck and upper back and control movements and sensation in the arms, is affected. When a part of this nerve bundle becomes compressed, it accounts for neurological TOS symptoms.

Symptoms of Thoracic Outlet Syndrome

• Pain in the neck, shoulder, and arm
• Numbness or tingling in the arm, hand, or fingers
• Weakness in the arm or hand
• ‘Tiredness’ or ‘fatigue’ in the arms and hand muscles of the affected side
• Cold hand or arm
• Swelling or discoloration in the arm
• Weak or no pulse in the affected arm

Diagnosis of Thoracic Outlet Syndrome

Diagnosis involves a thorough medical history and appropriate neurological and orthopedic examination. Further investigations including X-rays can be helpful in identifying underlying structural factors that may be contributing to the condition. In some cases, additional tests such as MRI, CT scans, or vascular studies may be necessary to confirm the diagnosis.

Thoracic Outlet Syndrome Treatment

The best treatment for thoracic outlet syndrome often involves a multidisciplinary approach. Treatment options may include:

• Physical Therapy: This is often the first line of treatment. A physical therapist can guide you through exercises to strengthen and stretch the muscles in the chest, shoulder girdle, and neck.
• Chiropractic Care: Chiropractors can help address underlying structural issues of the shoulder, neck, and spine, to encourage more space in the Thoracic Outlet.
• Medications: Over-the-counter pain relievers or anti-inflammatory drugs may help manage pain. In some cases, your doctor might prescribe muscle relaxants.
• Lifestyle Modifications: This could include ergonomic adjustments at work, posture improvement, and avoiding activities that exacerbate symptoms.
• Surgery: In severe cases or when conservative treatments fail, surgery may be recommended to relieve compression on the affected nerves or blood vessels.

At Clinic 27, we use the Advanced Biostructural Correction™ (ABC) protocol, which includes meningeal releases, a powerful stretching technique of the spinal nerves which can help to reduce neural tension, specifically in the brachial plexus.

Thoracic Outlet Syndrome Exercises

Exercises play a crucial role in both treating and preventing TOS. Here are some beneficial exercises:

• Shoulder Blade Squeeze: Squeeze your shoulder blades together, hold for 5 seconds, then release. Repeat 10 times.
• Neck Stretch: Gently tilt your head to one side, bringing your ear towards your shoulder. Hold for 15-30 seconds, then repeat on the other side.
• Chest Stretch: Stand in a doorway with your arms on the door frame at shoulder height. Lean forward to feel a stretch in your chest muscles.
• Scalene Stretch: Gently tilt your head back and to the opposite side of the tight muscle. Hold for 15-30 seconds.
• Posture Correction: Practice sitting and standing with proper posture throughout the day.

Remember to consult with a healthcare professional before starting any new exercise regimen, especially if you’re experiencing pain or discomfort.

Can Thoracic Outlet Syndrome Go Away?

With proper treatment and management, many people with TOS experience significant improvement in their symptoms. In some cases, symptoms may resolve completely. However, the timeline for recovery can vary greatly depending on the severity of the condition and the underlying causes.

For mild cases caught early, symptoms may improve within weeks to months with conservative treatment. More severe or chronic cases may require ongoing management and could take several months to a year to see significant improvement.

It’s important to note that even after symptoms improve, ongoing exercises and posture awareness are often necessary to prevent recurrence. Some individuals may need to make long-term lifestyle modifications to manage their condition effectively.

Conclusion

While TOS can be a challenging condition, with proper diagnosis, treatment, and self-care, many individuals can find relief and return to their normal activities. If you’re experiencing symptoms of TOS, don’t hesitate to seek professional help. Get in touch with us today through the Contact Us form at Clinic 27 to start your journey towards relief and recovery.