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Thoracic Outlet Syndrome
Selected Features of Our Program
- Specific criteria used to establish diagnosis
- Emphasis on non-surgical treatment
- Multi-disciplinary team approach
Evaluation and Diagnosis
Thoracic Outlet Syndrome
is the name given to pinching of the arm's nerves as they pass through
the shoulder region. The condition occurs in patients who have anatomic
abnormalities in this area. Symptoms are made worse by posture and
work habits. The main symptom is pain that runs down the limb as
well as a sense of heaviness in the arm. Numbness and tingling,
weakness, and loss of coordination occur in more advanced cases.
Many patients who complain of similar symptoms are automatically
thought to have thoracic outlet syndrome. However, a thorough examination
by a physician experienced in nerve disorders is needed to actually
make the diagnosis using specific criteria. X-rays are taken to
look for bony abnormalities that are known to be associated with
thoracic outlet syndrome. An MRI scan may produce an image of the
nerves being compressed with certain arm positions. MRI can also
show compression of nearby blood vessels that run with the nerves.
Electrical nerve studies are necessary to assist in localizing the
area of nerve compression and provide information about severity.
Treatment and Recovery
A strong emphasis is
placed on non-surgical treatment. Therapy focuses on postural retraining
and breaking bad ergonomic work habits. Stretching of the muscles
on the front of the chest is balanced out with strengthening the
muscles in the back. Weight reduction is important for heavier patients.
Surgery is seldom required for thoracic outlet syndrome. Patients
who have clear abnormalities on one of the studies or involvement
of the blood vessels, make better candidates for surgery. Decompression
of the nerves can be done through the armpit or over the collarbone
by removing scar bands around the nerves and part of the first rib.
Surgery is followed by an early, active therapy program that emphasizes
returning to normal activities as quickly as possible. In most cases,
light work can be resumed within a few weeks. Heavy lifting and
labor takes longer to recover.
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