THORACIC OUTLET SYNDROME

Thoracic Outlet Syndrome (TOS) is characterized by the compression of the nerves, arteries, and veins in the thoracic outlet. This is the space between the collarbone and the first rib.

TOS can result in a range of symptoms, including pain, tingling, and weakness in the upper limbs. TOS can also reduce blood flow to the arm and hand, causing coldness, discoloration, and swelling. To diagnose TOS, your healthcare professional uses information from physical examination, imaging studies, and nerve conduction studies.

On this page, we will discuss the causes of thoracic outlet syndrome, as well as the signs and symptoms of this condition.

After that, we will list a few complications that could arise from untreated thoracic outlet syndrome. Finally, we will review the science that studies the effects of chiropractic care in the management of thoracic outlet syndrome.

What are the causes of thoracic outlet syndrome?

Causes of thoracic outlet syndrome:

Anatomical Variations

Structural variations in the bones, muscles, and nerves in the thoracic outlet region can increase the likelihood of developing TOS. This includes conditions, such as cervical rib, elongated transverse processes, and scoliosis (insert link).

Repetitive Strain Injuries

Repetitive overhead activities, such as throwing a ball or lifting weights, can cause injury to the soft tissues in the thoracic outlet. This type of injury can lead to chronic pain and discomfort.

Trauma

Traumatic injury to the neck or upper extremities can cause damage to the structures in the thoracic outlet region, leading to TOS. This includes injuries, such as fractures, dislocations, and sprains.

Pregnancy

Pregnancy causes physiological modifications in the body that increase pressure on the thoracic outlet, including weight gain, fluid accumulation, and changes in posture.

Occupational Demands

Certain occupations that require repetitive overhead movements, prolonged periods of sitting, and prolonged use of vibrating tools can increase the risk of TOS. Examples are jobs in construction, manufacturing, and office work.

Obesity

Excess weight increases the pressure on the structures in the thoracic outlet, leading to TOS. This is particularly true in individuals who carry excess weight in the upper body.

What are the signs and symptoms of thoracic outlet syndrome?

Signs and Symptoms of thoracic outlet syndrome:

Pain in the neck and shoulders

Pain in the neck and shoulders is a common symptom of TOS. The pain may be constant or intermittent and can range from a dull ache to sharp stabbing pain.

Numbness and Tingling

Numbness in the arms and hands is another common symptom of TOS. This is due to compression of the nerves in the thoracic outlet region.

Weakness

Weakness in the upper extremities is another symptom of TOS. This is due to compression of the nerves and blood vessels in the thoracic outlet region, leading to reduced circulation and nerve function.

Swelling

Swelling in the arms and hands can be a symptom of TOS, particularly in individuals with more severe compression of the blood vessels in the thoracic outlet region.

Cold Sensation

You may also experience coldness in the arms and hands due to reduced circulation in the thoracic outlet region.

Decreased Range of Motion

Decreased range of motion in the neck, shoulders, and arms often accompanies TOS. This may be due to the pain and discomfort associated with movement in the thoracic outlet region.

Fatigue

The chronic pain and discomfort associated with the condition may lead to fatigue. Unfortunately, chronic fatigue can lead to decreased physical activity and compromised quality of life.

The complications of thoracic outlet syndrome

Chronic pain

TOS can lead to chronic pain in the neck, shoulders, arms, and hands. This will undoubtedly have a negative impact on your quality of life.

Nerve damage

Nerve compression in the thoracic outlet region causes permanent nerve damage and muscle weakness.

Blood vessel damage

Compressing blood vessels is another consequence of TOS. This may increase the risk of blood clots.

Arthritis

Chronic inflammation in the shoulder and neck joints may put you at risk of arthritis.

Decreased range of motion

Chronic TOS can lead to decreased range of motion in the neck, shoulders, and arms.

Physical and emotional stress

Chronic pain combined with decreased physical function can precipitate physical and emotional stress in individuals with TOS.

Reduced productivity

TOS can impact an individual’s ability to perform their job, leading to decreased productivity and financial issues.

The role of chiropractic care in the management of thoracic outlet syndrome

Chiropractic care can play a role in the management of thoracic outlet syndrome by reducing pain, improving range of motion, and promoting healing of the affected structures.

Here are a few studies that investigated the role of chiropractic care in TOS:

A 2011 study found that chiropractic care is effective in reducing pain and improving function. The study concluded that after a few weeks of chiropractic care, the patient reported a significant decrease in pain and an improvement in range of motion.

Another systematic review evaluated the effectiveness of chiropractic care in the management of TOS. The review included several studies with hundreds of participants and found that chiropractic care was effective in reducing pain and improving function. The authors of the study noted that these results can match other medical interventions without the side effects. Additionally, a case series that included 20 participants also confirmed these results.

Despite the limited number of studies, these results are quite promising and suggest a greater role of chiropractic care in the management of thoracic outlet syndrome.

Takeaway message

Thoracic outlet syndrome is a serious condition that can negatively impact your quality of life when left untreated. Luckily, there is growing evidence that chiropractors can actually help patients with this condition without having to deal with the side effects of pharmacological drugs.

We hope that this article managed to highlight the potential role of chiropractic care in the treatment of thoracic outlet syndrome.

If you have any specific questions about chiropractic care or thoracic outlet syndrome, feel free to share your thoughts in the comment section below.