Thoracic Outlet Syndrome: What It Is & How to Fix It (Permanently!)

Have you recently been diagnosed with thoracic outlet syndrome? At Elite HP, we understand how crucial it is to fully grasp your condition, the thoracic outlet syndrome symptoms you may be experiencing, and the most effective path forward. 

In this article, we'll walk you through what thoracic outlet syndrome is, how it's diagnosed, and what thoracic outlet syndrome treatment options are available, including how our thoracic outlet syndrome program at Elite HP can support your recovery.

What Is Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is caused by entrapment or compression of important structures, either nerves or blood vessels, as they pass through the upper chest and shoulder region. 

Most commonly, it involves nerve compression of the brachial plexus, known as neurogenic thoracic outlet syndrome, as it travels from the neck into the shoulder through tight or overactive muscles. In some cases, vascular thoracic outlet syndrome may occur when arteries or veins are compressed instead.

This condition often develops due to prolonged periods of sitting with a forward shoulder posture or from repeated forceful trauma during high-intensity activities like CrossFit.

How To Diagnose Thoracic Outlet Syndrome

Diagnosing Thoracic Outlet Syndrome accurately is a vital step toward a successful treatment plan. This condition can be complex, as it may present in several forms: neurogenic thoracic outlet syndrome (involving the nerves), arterial thoracic outlet syndrome, and venous thoracic outlet syndrome, which affects the veins. 

Each form is linked to different vascular conditions or nerve-related issues, so a proper evaluation is key.

Specialised assessments such as Allen's test and Adson's test are commonly used to identify the type of compression. For a thorough diagnosis, patients are often referred to a thoracic outlet syndrome center or a vascular surgeon with experience managing this condition.

Arterial Thoracic Outlet Syndrome

Arterial thoracic outlet syndrome occurs when a major blood vessel, the subclavian artery, becomes compressed as it passes through the thoracic outlet. 

This reduces blood flow to the arm, which can lead to pain, coldness, paleness, and even tissue damage in the hand or fingers. For the patient, these symptoms can develop gradually or appear after physical activity.

Allen's Test

Allen's test is a straightforward method that can help detect signs of arterial compression. While this isn’t a substitute for professional evaluation at a vascular center, it can provide useful initial insights into your symptom pattern.

To perform the test:

• Raise the arm on the affected side and rapidly open and close your hand for about a minute.

• Lower the arm and observe your palm.

• If your palm remains pale for several seconds, this may indicate reduced arterial blood flow, a possible sign of arterial thoracic outlet syndrome.

Nerve Thoracic Outlet Syndrome

Nerve thoracic outlet syndrome, also known as neurogenic thoracic outlet syndrome, is the most common type. It stems from compression of the brachial plexus nerves, often as they pass through tight muscles or due to postural issues affecting the cervical spine. 

This condition can produce a variety of symptoms, including aching pain in the neck, shoulder, and arm, as well as numbness and hand weakness. It's sometimes misdiagnosed as other neurological disorders, which makes accurate testing essential.

Adson's Test

Adson's test is another simple at-home screening method that may indicate nerve-related thoracic outlet syndrome. Though not a replacement for assessment by a physical therapist, it can help narrow down the best treatment option.

To perform the test:

• Sit or stand upright. Extend your affected arm out to the side with the thumb pointing up.

• Take a deep breath and hold it while turning your head toward the affected side.

• A positive result occurs if you experience tingling or numbness in the arm or if your radial pulse disappears.

These two tests can provide you with helpful insights into your condition and guide you on your next steps. However, they are not a definitive diagnosis. 

To confirm your condition and explore options like thoracic outlet decompression or TOS surgery, we recommend seeking professional help from a Brisbane physiotherapist.

Treatment for Thoracic Outlet Syndrome

When it comes to treating Thoracic Outlet Syndrome (TOS), the approach depends largely on the severity of your condition, the type of TOS (arterial or nerve), and your individual health profile. The primary aim is to relieve compression and restore normal function, and this can be achieved through a variety of methods. Let's discuss some common treatment approaches:

Physical Therapy

Often, the first line of treatment for TOS, especially in cases of nerve thoracic outlet syndrome, is physical therapy. This form of treatment is spearheaded by professional physiotherapists who work with you to create a personalised plan targeting the specific muscles and areas affected by your condition.

Therapeutic Exercises

In most cases, your physiotherapist will guide you through a series of exercises designed to stretch and strengthen the muscles surrounding the thoracic outlet.

These exercises are crucial for improving posture, enhancing mobility, and reducing nerve or artery compression. If you are local, our Brisbane physiotherapists can do this with you.

Manual Therapy

Manual therapy is another aspect of physical therapy where your physio applies hands-on techniques to manipulate your muscles and joints. This can help to improve the range of motion and reduce compression on the nerves and blood vessels.

Lifestyle Modifications

In many cases, simple lifestyle changes can have a significant impact on the management and recovery from TOS. This can include modifications to your workplace ergonomics, changes in your sleeping habits, or tweaks in the way you perform certain activities.

A Brisbane physio can guide you through these adjustments to ensure they effectively contribute to your recovery.

Medication and Surgical Interventions

For some, medication may be used to manage pain and inflammation associated with TOS. In more severe cases where non-invasive treatments do not provide relief, surgical interventions may be necessary to decompress the area. It's important to remember that these options should always be discussed with a healthcare professional.

Remember, an early diagnosis and treatment can make a significant difference in managing Thoracic Outlet Syndrome. If you suspect that you're experiencing symptoms related to this condition, consider reaching out to our Brisbane physiotherapy clinic at Elite HP.

Our team of dedicated physiotherapists is on standby to help you navigate your treatment options and get you on the path to recovery.

Conclusion

With the right knowledge and treatment plan, thoracic outlet syndrome doesn't have to limit your daily activities. These exercises should guide you through your injury and help you on your way to recovery. However, if you find you need more support, don't hesitate to seek professional help.

For more advice and personalised treatment plans, visit us at Elite HP, a leading Brisbane physiotherapy clinic.

Our Brisbane physiotherapists are highly trained and experienced in handling various injuries, including thoracic outlet syndrome. If you're looking for a dedicated Brisbane physio to help you on your recovery journey, reach out to us at Elite HP today.

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