What is Thoracic Outlet Syndrome?
The Thoracic Outlet is the opening at the top of the Thoracic Cavity. It is essentially a hole through a bony ring, that several vital structures pass through. Thoracic Outlet Syndrome occurs when one or more of these vital structures are compressed. In 95% of cases, Thoracic Outlet Syndrome affects the neurological system, specifically the Brachial Plexus. In 4% of cases the venous system is affected, and in less than 1% of cases, the arterial system.
What are the symptoms of Thoracic Outlet Syndrome?
Symptoms of Thoracic Outlet Syndrome are often vascular or neurological, depending on the structures that are compressed, they include:
- Pins and needles down the arm
- Numbness down the arm or in the hand
- A Cold feeling down the arm or in the hand
- Weakness in the arm or hand
- Pain located in the shoulder or closer to the neck.
What caused my Thoracic Outlet Syndrome?
The most common cause of Thoracic Outlet Syndrome is trauma, such as a whiplash injury or traction injuries. It is also common for postural changes, such as forward head posture or rounded shoulders to place repetitive strain on structures in the Thoracic Outlet. Less commonly, congenital changes, such as; cervical ribs, abnormal transverse processes or connective tissue abnormalities can compress the structures in the Thoracic Outlet. More pressing medical conditions, such as; tumours, hyperostosis or osteomyelitis can cause Thoracic Outlet Syndrome, your physiotherapist will asses to rule out any signs that this may be the case.
How can you help me with my Thoracic Outlet Syndrome?
Your treatment plan will be specific to your condition, and guided by the results of your physiotherapists detailed assessment. Typically, treatment will involve techniques to reduce the compression of structures in the Thoracic outlet. You will also receive a mixture of manual techniques, exercise and advice to address the contributing factors, such as posture and mobility, in order to prevent any recurrence. Your physiotherapist will be able to assess for the presence of any abnormal symptoms, and in this case will organise a referral to your GP for further investigation or scanning.
What should I do to avoid aggravating my Thoracic Outlet Syndrome?
- Avoid sitting or standing with slumped posture.
- REMAIN ACTIVE, but avoid your aggravating activities.
- RECEIVE physiotherapy care to get your joints, ligaments and muscles performing to their optimal level
Keep good care of your body and your physiotherapist will continue to monitor your condition. Once your Thoracic Outlet Syndrome has resolved you will be able to resume your full activities without worrying about future flare-ups.