How Physical Therapy Can Treat Thoracic Outlet Syndrome

Symptoms can start off somewhat vague. Pain can be felt in the neck and shoulder accompanied by tingling in the hand, especially if a lot of time is spent in front of a computer. Pain in the hands and shoulders may worsen, while patients may begin to feel cold in the fingers. Thoracic outlet syndrome can start out quite benign, but if left untreated, patients’ conditions can deteriorate to the point of diminishing the ability to work and participate in their daily lives.

What is thoracic outlet syndrome?

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

  • Numbness in the fingers
  • Pain in shoulder, neck and arm.
  • Alteration 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 exit passage of these nerves and blood vessels from the thorax to the upper extremities. OT is bordered by muscles, bones, and other tissues, and any resulting muscle, bone, and other tissue problems 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, weight lifting, however it should be noted that sometimes not, sometimes there is no detectable cause.

How to treat thoracic outlet syndrome

  1. Posture training: The first protocol in treating TOS is to assess postural problems in daily activities, at work, and at rest to reestablish posture as needed to decrease pressure on the thoracic passage.
  2. Manual therapy: The focus of manual therapy is to increase the range of motion in the shoulder girdle and 1/2 ribs. This will also aid in the patient’s ability to maintain the postural adjustments of the postural training.
  3. Transcutaneous electrical nerve stimulation or TENS: TENS or EMS is a pain treatment modality that uses low-voltage electrical current that causes the local release of neurotransmitters such as serotonin that block pain signals in the brain.
  4. Kinesio tape: In addition to the helpful benefits Kinesio tape has in relieving pain, reducing swelling, and improving lymphatic function; Kinesio tape is also helpful in helping patients maintain proper posture.
  5. Therapeutic exercise: In order for patients to maintain proper posture to relieve pressure, they must have the strength and flexibility to do so. In addition to exercises performed in a physical therapy session, home exercise programs using exercises such as thoracic extension and rowing are necessary to successfully treat thoracic outlet syndrome.

TOS is one of those diagnoses that starts out more as a nuisance. However, if left untreated, it can become a source of disability and the need for surgical intervention. In our computer and technology-driven lifestyle, patient posture continues to degrade, putting most patient populations at risk for developing TOS. It is important for patients to understand that treatment is available and that early intervention is key.

Written by Sara Zuboff

January 10, 2021
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