Chiropractic Treatment of Thoracic Outlet Syndrome

Physical TherapyThoracic Outlet Syndrome can be defined as a Neurovascular Compression Syndrome of the Subclavian Artery Vein and the Brachial Plexus nerve roots C-5 through T-1 between the clavicle and the first rib. Thoracic Outlet Syndrome or TOS for short can result in pain in the neck, shoulders and arms. It also can result in numbness or tingling in the hands and arms. The exact cause of TOS may not always be able to be determined. However, it may be triggered from a physical trauma like a whiplash from a motor vehicle accident or Stinger caused by a neck injury from playing football. Structural abnormalities such as forward rounded shoulders or a cervical rib or an over developed chest can also predispose a person to developing this condition. TOS can also be caused by repetitive use of the upper extremities.\

A Chiropractor would typically diagnose this condition by performing a thorough history, orthopedic and neurological examination of the cervical spine and upper extremities. In some cases, x-rays or electrodiagnostic studies of the cervical spine and upper extremities may be performed to rule out other causes or conditions. Typically, the symptoms and a few key orthopedic tests like Roo’s and Adson’s tests will be most indicative when positive i.e…. reproducing the signs and patient symptoms.

Chiropractic treatment of TOS may include CMT chiropractic Manipulative Therapy to the Cervical and Thoracic Spine, first rib and articulations of the elbow, wrist and hand. Soft Tissue Manipulation may be performed to the muscles of the Cervical Spine specifically the Anterior and Middle Scalene muscles which compose the Scalene Triangle. The clinical significance of these muscles is the Neurovascular Bundle composed of the Subclavian Artery, Vein, and Brachial Plexus nerve roots C-5 through T-1 pass through this triangle before their passage between the clavicle and first rib. If these muscles shorten due to chronic persistent muscle spasm or scar tissue or adhesions formed due to a whiplash type injury to the neck compression of the neurovascular bundle may occur. Soft tissue manipulation applied to the Scalene muscles may reduce the compressive effect upon the structures that pass through the Scalene Triangle.  Passive modalities such a moist heat, electric stimulation, or ultrasound may be useful to increase circulation, soften and relax the muscles prior to the application of CMT to the involved osseous and soft tissues.

Dr. Mininsohn is a Chiropractor and Acupuncturist and has been in practice since 1990. He is currently employed at the Brick office of Advanced PMR. He is available for Consultation Monday, Tuesday, Wednesday and Friday from 8:00 AM to 7:00 PM.

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