What is Thoracic Outlet Syndrome?
The thoracic outlet is a small opening made up of soft tissue and bony structures including the ribs, the collarbone and the musculature of the neck and shoulder that allows a variety of neurovascular structures to pass down from the neck and supply the arm, chest and shoulder blade. Any narrowing of this small space can cause these nerves and blood vessels to become compressed which is commonly referred to as “Thoracic Outlet Syndrome”.
What are the signs and symptoms of Thoracic Outlet Syndrome?
Signs and symptoms vary from patient to patient depending on what structures are affected. In most cases the brachial plexus is affected – a cluster of nerve roots exiting from the cervical spine.
If neural tissue is compressed as it exits through the thoracic outlet symptoms may include pain anywhere between the neck, face, chest, shoulder and arm, altered or absent sensation, weakness and fatigue or feeling of heaviness in the arm that increases when the arm is in an overhead position.
If veins or blood vessels are affected, the skin can be blotchy or discoloured and due to decreased blood flow a different temperature or pulse may be observed in the arm or hand.
Who is usually affected by Thoracic Outlet Syndrome?
Thoracic Outlet Syndrome has an average incidence between 3 to 80 cases per 1000 people and is 3-4 times as common in women compared to men between the ages of 20 and 50. There are several factors that are often associated with Thoracic Outlet Syndrome including tightness or shortening of the musculature in the front of the chest and the neck including the pec minor and scalenes, anatomical abnormalities present from birth such as extra ribs, postural factors such as rounded shoulders or altered spinal curvatures, dropped shoulders or a whiplash or hyperextension injury of the neck.
How can physiotherapy help with Thoracic Outlet Syndrome?
Physiotherapists can help with the management of your Thoracic Outlet Syndrome through correcting your posture, stretching and strengthening various muscles around the neck and shoulder to help reduce compression of the neurovascular structures and manual therapy techniques such as taping, soft tissue massage and joint mobilisations.
If you would like some personalised advice regarding your discomfort book an appointment with you Physiotherapist today.
