The thoracic outlet is a small space located in between the collarbone and the first rib. Passing through this space are nerves, blood vessels and veins. Unfortunately, there are times when this outlet becomes compressed. This results to a condition known as thoracic outlet syndrome (TOS).
Causes of Thoracic Outlet Syndrome
There can be various causes of thoracic outlet syndrome. It could be due to congenital conditions that can cause impingement to the structures inside the thoracic outlet. For instance, an extra growth of rib can cause compression to the brachial plexus. Another congenital condition is a tight fibrous band between the rib and the spine.
Poor posture can also cause thoracic outlet syndrome. A forward head position or a stooped posture can compress the structures in the thoracic outlet. Impacts to the shoulder area due to physical trauma can also cause inflammation and compression of the thoracic outlet.
Repetitive movements and activities can also cause thoracic outlet syndrome. Clerks, secretaries, typists, librarians and factory workers are more prone to thoracic outlet syndrome because they often use their upper extremities for work.
Symptoms of Thoracic Outlet Syndrome
TOS is often difficult to diagnose because it has varying symptoms. The symptoms differ due to varying sites of compression. Most of the time, the following signs and symptoms can be observed when nerves are compressed:
- Numbness or tingling sensation in the neck and shoulder area extending to the arm, hand and fingers
- Pain in the affected hand or fingers
- Weakened grip resulting to difficulty in doing fine motor tasks
On the other hand, if blood vessels are compressed, the following symptoms can be observed:
- Cold hands and fingers
- Swollen arm and hand
- Hand discoloration (turns bluish)
- Arms and hands are easily fatigued
- Pain felt deep in the collar bone and shoulder area
- A lump in the collar bone that may be painful
Diagnosis and Treatment of Thoracic Outlet Syndrome
Chiropractors also treat thoracic outlet syndrome. Upon initial visit he may request for diagnostic examination such as X-ray, MRI, nerve conduction velocity test or extra lab tests to accurately diagnose the problem.
Some of the treatment plan a chiropractor will perform includes joint mobilization, stretching, soft tissue mobilization, and physical therapy modalities to relieve pain, swelling and compression. Your chiropractor may recommend a home exercise program for your condition. Care must be taken to prevent bouncy and sudden movements that can cause further injury. Although stretching to the farthest point possible is recommended, it should be done only to the point where there is no pain felt. The focus of the exercises will be stretches to the neck and shoulder muscles as well as the muscles in the chest region ( e.g. pectoralis).
Your chiropractor may also advise you to avoid positions that can aggravate the condition such as repetitive overhead movements, sleeping with arms stretched upwards and sleeping on your stomach with arms stretch overhead.
Call or visit a chiropractor today. He can provide expert opinion regarding your condition and provide with you with a specialized exercise program for your condition.
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