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What is thoracic outlet syndrome?

Thoracic outlet syndrome is a nerve compression that is very common in the shoulder. two of the three main nerves traveling down the arm go under a muscle called the pectoralis minor in the shoulder. It is very common in people with rounded or rolled forward shoulders to have tightness of the pectoralis minor muscle. This tightness compresses the nerves when our arm is in certain positions especially while sleeping on your side.  Patients will note they wake up in the night with a numb hand.  It is also common for people the experience pain in the upper back and shoulder. This is because of strain of these muscles related to rounding of the shoulders forward. This is common to see in people who work on computers, weight lifters, and people who play sports such as tennis or baseball.

Commonly thoracic outlet is a combination of 2 nerve impingements referred to as a double crush syndrome. The second impingement is between the scalene muscles and the first rib in the lower neck.  The second impingement called Scalene Syndrome is always suspected when a person experiences numbness in the hand.  This syndrome is also the result of tight muscles resulting in nerve compression.  It is also commonly associated with forward head posture referred to as anterior head carriage.

What is the treatment ?

Chiropractic Care in conjunction with Massage Therapy and home stretching is very effective at eliminating Thoracic Outlet Syndrome. Treatment is focused on stretching the tight muscles in the chest and correcting the trigger point buildup in the upper back, neck, and shoulders.  If scalene syndrome is also involved treatment also addresses the tightness of the involved scalene muscles. In most cases posture issues at work need to assessed and corrected to aid in healing.

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