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Navigating the Complexities of Thoracic Outlet Syndrome:

Symptoms and Treatment Options

Article by Jason Racca

Photography by Canva

Thoracic Outlet Syndrome (TOS) often manifests with symptoms that can easily be misinterpreted. When a patient experiences pain into the arms and hands, nausea, dizziness, coldness, numbness/tingling, or tunnel vision, especially with arm movements above the head, it's crucial to consider TOS as a potential cause. These symptoms suggest more than just musculoskeletal issues; they hint at possible neurological or vascular complications.

Identifying Thoracic Outlet Syndrome:

TOS is a condition where the blood vessels or nerves that come out of the neck and/or between the collarbone (clavicle) and the first rib become compressed. This can lead to a variety of symptoms, including:

  • Numbness/tingling into the arms/hands

  • Pain into the arms/hands

  • Nausea and dizziness when arms are raised

  • Sensation of impending fainting (pre-syncope)

  • Tunnel vision or visual disturbances

  • Temperature changes in the hands and arms

These symptoms are typically not associated with orthopedic conditions such as shoulder impingement but are indicative of the compression of neural and vascular structures.

TOS can improve!:

Manual therapy offers promising results for managing TOS. Treatment strategies might include:

  • Mobilization Techniques: Freeing up the nerve and vascular entrapments around the neck, underneath the collarbone, and through the pectoral area.

    • This may include soft tissue mobilizations, treating joints so they move better, or treating the mobility of the nerves as they pass through these structures.

  • Fascial Manipulation: Addressing the fascial connections that might contribute to the compression of neurovascular bundles.

    • This may be the fascia in the cervical spine, in the chest area, or more distant from the symptomatic area, including visceral manipulation (addressing how the organs move - this is important not just for the health of your musculoskeletal system, but other systems of the body as well.)

  • Postural Adjustments: Techniques aimed at improving posture to relieve pressure on the thoracic outlet.

Patients are encouraged to be proactive and question their diagnoses, especially when the suggested treatments do not align with their symptoms. For instance, surgeries aimed at addressing impingement might not resolve issues stemming from TOS.

Advocating for Accurate Diagnosis and Treatment:

It's essential for patients to understand their symptoms and seek second opinions if necessary. Educating oneself about the implications of various symptoms and potential treatments for TOS can lead to more effective management and avoidance of unnecessary surgical interventions.

For those suffering from similar symptoms or diagnosed with TOS, exploring manual therapy options can provide relief and a potential return to normalcy without the need for invasive procedures.

For more information on how to manage and treat Thoracic Outlet Syndrome through holistic physical therapy approaches, visit our website or contact us at R3 Physio, 817-221-8248. Our team is equipped to assess and treat complex conditions with a focus on comprehensive, patient-centered care.

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