Thoracic Outlet Syndrome - Chiropractic Treatment

Thoracic Outlet Syndrome
By Alejandro Katz, MD, OMD, LAc, QME

Frequently orthopedists, neurologists or chiropractors refer patients with a diagnosis of thoracic outlet syndrome. This article will help you know what it is and how to treat it.

The symptoms of thoracic outlet syndrome (TOS) are pain, numbness and tingling of the upper extremity.

The compression of the brachial plexus, subclavian artery and vein between the clavicle, first rib and the scalene muscles seems to be the cause. The nerves mostly affected are the radial; ulnar (90% of the cases); median; and musculoskeletal nerves. The patient's symptoms are pain/tingling/burning of the forearm/hand/fingers (third, fourth and fifth fingers). The pain medications usually prescribed include ibuprofen (600-800 mgs 2/3 times a day), naproxen (500 mgs two times/day), vioxx (12.5/25/50 mgs) or celebrex (100/200 mgs).

A diagnostic test that could be used for TOS is a nerve conduction study (NCS), which will show whether an abnormality is present (the test's results are usually inconsistent).

The examination is performed with the patient's head slightly extended and rotated toward the contralateral side of the area to be examined. Mild to moderate digital palpation is exerted on the scalene muscle rib insertion in order to find the active point(s) that will reproduce the patient's complaints (pain/numbness/burning or tingling, radiating to the upper extremity).

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