Thoracic Outlet Syndrome
By Erik Yuill – Chiropractor
The thoracic outlet is a small space between the clavicle and the first rib. Thoracic outlet syndrome (TOS) is a group of disorders that involve compression, injury, or irritation of the nerves, blood vessels, or veins in the thoracic outlet. This can cause pain in the shoulders and neck and numbness in the fingers.
Causes of the compression can vary and may include:
• Anatomical defects: Inherited defects present at birth, including a cervical rib (an extra rib located above the first rib) or an abnormally tight fibrous band connecting the spine to the rib.
• Poor posture: Slumping of the shoulders or holding the head in a forward position can cause compression in the thoracic outlet area.
• Repetitive activity: Doing the same activity over and over can wear on the body’s tissues. You may notice symptoms of thoracic outlet syndrome if your job requires continuous repetition of a movement.
• Tight muscles: Hypertonicity in certain muscles such as the scalenes, trapezius, subscapularis, pectoralis minor and coracobrachialis can compress the neurovascular structures which travel through the thoracic outlet area.
Treatment of TOS
In the vast majority of TOS cases, a conservative, non-surgical approach to treatment can be effective, especially when the condition is diagnosed early. A chiropractic treatment plan for TOS may include a mix of soft tissue manual release techniques, joint mobilization/manipulation, home stretching exercises, and postural education.
The primary goal of treatment is to decrease the tension within muscles and tissue that are causing compression on the neurovascular bundle and compromise nerve conduction or blood flow. Manual release techniques that specifically target the hypertonic muscles listed above can significantly decrease the symptoms associated with neurovascular compression and improve the quality of life for those with TOS.
Dr. Yuill has significant experience in treating TOS. Many other conditions such as carpal tunnel syndrome, tennis elbow, and shoulder impingement result from repetitive activities. Often these conditions, including TOS, are labeled as repetitive stress injuries (RSI) or cumulative trauma disorders (CTD). By manually treating the soft tissues causing tension on the nerves and vascular tissues responsible for numbness and pain with these conditions, many patients find a quick change in their symptoms. Manual therapy including Active Release Technique (ART) and fascial release are combined with corrective exercises to improve overall posture, as postural position can also contribute to this condition.
QubeCore Sports & Rehab offers chiropractic services in North Vancouver for a wide range of injuries and conditions. To book your appointment with Dr. Yuill, call 604.210.2274 or simply BOOK ONLINE