How physical therapy can treat thoracic outlet syndrome

The symptoms may start out rather vague. You may feel neck and shoulder pain accompanied by tingling in your hand, especially if you spend a lot of time in front of a computer. Hand and shoulder pain may worsen, while patients may begin to feel cold in their fingers. Thoracic outlet syndrome can start out fairly benign, but if left untreated, patients’ conditions can deteriorate to the point of reduced 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 fingers
• Shoulder, neck and arm pain.
• Deterioration and sometimes discoloration of the extremities.

TOS is caused by compression of the nerves and/or blood vessels in the upper chest. Thoracic outlet (TO) refers to the exit passage of those nerves and blood vessels from the thorax to the upper extremities. The TO is bordered by muscle, bone, and other tissue, and any problems that result in muscle, bone, and other tissue border the thoracic outlet. Any condition that causes inflammation of these tissues can cause thoracic outlet syndrome. Thoracic outlet can be caused by poor posture, a lot of computer work, weight lifting, however it should be noted that sometimes there is no detectable cause.

How to treat thoracic outlet syndrome

1. Posture Training: The first protocol in the treatment of TOS is to assess for postural problems in daily activities, work, and rest to restore 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 blocks pain signals in the brain.
4. Kinesio tape: In addition to the helpful benefits of Kinesio tape in relieving pain, reducing swelling, and improving lymphatic function; Kinesio tape is also useful 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 the exercises performed in a physical therapy session, home exercise programs using exercises such as the chest 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 lifestyles, patient posture continues to degrade, putting most patient populations at risk for developing TOS. It is important that patients understand that treatment is available and that early intervention is key.