Thoracic Outlet Syndrome

Thoracic outlet syndrome is a painful condition that is associated with neck pain, arm pain, numbness and weakness to the arms and hands. There can be several causes. In my practice, the most common cause is spasm and irritation of a group of muscles called the scalenes, which are located behind and under the clavicle (collar bone). Usually there is underlying dysfunction of the neck and upper back. In response to this, the scalene muscles go into spasm. There is also a degree of inflammation, which causes the surrounding tissue to swell. This will put pressure on a bundle of nerves called the brachial plexus. The brachial plexus has branches of nerves that control muscle and skin sensation to the arm and hand. The result of pressure on the brachial plexus is pain, weakness, and numbness to the arm and hand. Other causes of thoracic outlet syndrome include direct trauma and the presence of a cervical rib.

Treatment for thoracic outlet in my practice typically consists of chiropractic adjustments to the neck and upper back, as well as at the effected shoulder girdle. Heat and electric muscle stimulation is often used as an adjunct to help relieve muscle spasm. Home stretching and postural exercises are also added when the patient is ready.