What is the thoracic outlet syndrome?
Thoracic outlet syndrome is a condition whereby symptoms are produced from compression of nerves or blood vessels, or both, because of an inadequate passageway through an area (thoracic outlet) between the base of the neck and the armpit. The thoracic outlet is surrounded by muscle, bone, and other tissues. Any condition that results in enlargement or movement of the tissues of or near the thoracic outlet can cause the thoracic outlet syndrome. These conditions include muscle enlargement (such as from weight lifting), injuries, an extra rib from the neck at birth (cervical rib), weight gain, and tumors at the top of the lung (rare). Often no specific cause is found.
It is felt by some researchers that the evolution of the torso of primates from a four-legged to a two-legged position may predispose humans to the development of thoracic outlet syndrome. The resulting vertical posture produced flattening of the chest cage and a shift of the shoulder joint backwards, both of which narrowed the thoracic outlet.
What are symptoms of thoracic outlet syndrome?
Symptoms include neck, shoulder, and arm pain, numbness, or impaired circulation to the extremities (causing discoloration). Often symptoms are reproduced when the arm is positioned above the shoulder or extended. Patients can have a wide spectrum of symptoms from mild and intermittent, to severe and constant. Pains can extend to the fingers and hands, causing weakness.
Figure 1 Figure 2
*Rotation and Extension of Head *Abduction of arm(Compression from Scalenus Anticus muscle) (Compression from Pectoralis Minor muscle)
How is thoracic outlet syndrome diagnosed?
The diagnosis of thoracic outlet syndrome is suggested by the symptoms and supported by findings of the doctor during the examination. Certain maneuvers of the arm and neck can produce symptoms and blood vessel "pinching" causing a loss of pulse. Further supportive testing can include electrical tests, such as EMG and somatosensory evoked responses (although these may not be positive in all patients). Some patients can have angiogram x-ray tests that demonstrate the pinched area of the blood vessel involved.
Can Chiropractic Help?
Thoracic outlet syndrome, like any other condition that affects the nerves, muscles and blood vessels, needs to be treated as soon as symptoms become apparent. Visiting your Chiropractor should be their first order of business. In most instances the Chiropractor is best suited to treat the nerve impingement that is certainly present. He/she will find the cause of impingement and treat the patient to remove the causative factor. He/she will also treat the patient with adjunctive therapies, such as, electric muscle stimulation, ultrasound, trigger point massage therapy and diathermy,
The patient will generally respond well to this therapy and Chiropractic treatment. However, it is up to the patient to help in their treatment. With home healthcare, they will speed their recovery while alleviating the pain that will be ongoing as they receive treatment from their Chiropractor or their Physician. Using an analgesic gel such as BIOFREEZE with Ilex can relieve pain and muscle spasms. The use of a vibrator such as the MEDISANA VARIOTHERM MASSAGER or a type of percussive, vibratory instrument plus a magnet in the head that adds multiple therapy adjuncts, can be very soothing. The alternate use of hot and cold packs in conjunction with the vibration will also be beneficial in increasing circulation and removing toxins from the muscles. It will also relieve the spasms that may be present. Maintaining an exercise program, such as the DOCTOR'S SENIOR EXERCISE (55 and above) program will prevent muscle atrophy, keeping the muscles strong and flexible.