How Physical Therapy Can Treat Thoracic Outlet Syndrome

Symptoms can start out somewhat vague. Pain may be felt in the neck and shoulder accompanied by tingling in the hand, particularly if a lot of time is spent at a computer. Hand and shoulder pain may worsen, while patients may begin to feel coldness in their fingers. Thoracic outlet syndrome may start out benign enough, but if left untreated, patients conditions may deteriorate to the point of decreased ability to work and participate in their day-to-day life.

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome (TOS) is a condition which symptoms include:

  • Numbness in fingers
  • Pain in shoulder, neck and arm
  • Impaired and sometimes discoloration of the extremities

TOS is caused by compression of nerves and/or blood vessels in the upper chest. The thoracic outlet(TO) refers to the exiting passage for those nerves and blood vessels out of the chest into the upper extremities. The TO is bordered by muscles, bone and other tissues and any issue that results in muscle, bone, and other tissues border the thoracic outlet. Any condition that results in swelling of these tissues can cause thoracic outlet syndrome. Thoracic outlet can be caused by poor posture, extensive computer work, weightlifting, however it must be noted that sometimes no sometimes there is no detectable cause.

How to Treat Thoracic Outlet Syndrome

  1. Posture Training: The first protocol in treating TOS is assessing postural problems in day-to-day activities, work and at rest to reset the posture as needed in order to decrease the pressure on the thoracic passage.
  2. Manual Therapy: The focus of manual therapy is increasing range of motion in the shoulder girdle and the 1/2 ribs. This will also aid in the patient’s ability to maintain the postural adjustments of the posture training.
  3. Transcutaneous Electrical Nerve Stimulation or TENS: TENS or EMS is a pain treatment modality that uses low voltage electric current which causes the local release of neurotransmitters such as serotonin which block pain signals in the brain.
  4. Kinesio Tape: In addition to the useful benefits Kinesio tape have in pain relief, swelling reduction and improvement in lymph function; Kinesio tape is also useful for helping patients maintain proper posture.
  5. Therapeutic Exercise: In order for patients to be able to maintain proper posture to relieve the pressure, they must have the strength and flexibility to do so. In addition to exercises done in a physical therapy session, home exercise programs using exercises such as thoracic extension and rowing are necessary for successfully treating thoracic outlet syndrome.

TOS is one of those diagnoses that start out more as an annoyance. However, if left untreated, it can become a source of disability and need for surgical intervention. In our computer and technology driven lifestyles, patient’s posture continue to degrade putting most patient populations at risk for developing TOS. It’s important for patients to understand that treatment is available and early intervention is key.

Michael Ortiz

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