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Thoracic outlet syndrome - About thoracic outlet syndrome and what we can do to help
Thoracic outlet syndrome
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Thoracic Outlet Syndrome describes a collection or symptoms; pins and needles, numbness and maybe pain in the arm and hand. These symptoms are caused by either the nerve or the blood supply into the arm becoming compressed, and in the case of the nerve, irritated.
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What causes Thoracic Outlet Syndrome?
The nerves can be compressed as they come out of the neck. They tend to be compressed by muscles called ‘scalenes’ since on each side a pair of these muscles form a V shape. If these muscles are too tight, for whatever reason, the V can start to close like a pair of scissors compressing the nerves.
The second place where compression can occur is between your collarbone and your 1st rib. This may also be due to tight scalenes holding the first rib elevated or can be due to dysfunction of the joints between the first rib and the spine or indirectly because of poor function of other joints in the area. In some patients there are unusual anatomical features such as extra ribs, which may also contribute.
The third place is underneath your pectoralis minor muscle. This small muscle sits deep to the larger pectoralis major. Long hours driving a desk coupled with poor stretching and weak back muscles can lead to this muscle becoming shortened. The nerves and blood supply run underneath pec minor, so any shortening can lead to additional tension on the neurovascular bundle.
The second place where compression can occur is between your collarbone and your 1st rib. This may also be due to tight scalenes holding the first rib elevated or can be due to dysfunction of the joints between the first rib and the spine or indirectly because of poor function of other joints in the area. In some patients there are unusual anatomical features such as extra ribs, which may also contribute.
The third place is underneath your pectoralis minor muscle. This small muscle sits deep to the larger pectoralis major. Long hours driving a desk coupled with poor stretching and weak back muscles can lead to this muscle becoming shortened. The nerves and blood supply run underneath pec minor, so any shortening can lead to additional tension on the neurovascular bundle.
How can we help?
Our role is to identify which structures are causing the problem and then to work with you to devise a treatment plan to help address these issues and a stretching and exercise regime to prevent a recurrence. Treatment can be very effective
When should you see a doctor?
If symptoms come on suddenly, particularly if they are the result of an accident; if you have noticed a cough, any lumps in your armpits or in your breast area; if you are dropping things or have noticed any clumsiness or any wasting of your muscles; if you associate arm discomfort with shortness of breath, chest pain or palpitations; if you have similar symptoms in your feet and legs, perhaps a sock and glove distribution, or if you have noticed any disturbance in your vision, hearing or speech, or are experiencing any confusion please see your doctor or visit accident and emergency.
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