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One of the more common conditions that walks into a chiropractor’s office but you don’t hear much about is called “Thoracic Outlet Syndrome” (TOS). This is a condition which is not terribly serious but the symptoms can be very scary and if left long enough can cause become fairly debilitating.
First of all let’s look at what this condition is and what causes it. The Thoracic Outlet is the triangle shaped space between your collar bone, shoulder blade, and the base of your neck. Through this space all of the arteries, veins, and lymphatic ducts travel to and from the chest cavity (Thorax) and out into the arm. These structures are also joined by the nerves from the neck that travel to the muscles and skin of the arm. That is a lot of stuff going through a fairly small area. Thoracic Outlet Syndrome occurs when any or all of the nerves, arteries, or veins become compressed which causes pain, numbness, and or tingling, in the hand and arm
The compression of these structures can happen in several different ways but most are due to poor posture, specifically hunching of the upper back (Thoracic spine), rolling forwards of the shoulders, and the head pushing forward in front of the shoulders. Any or all of these postural positions will stress and strain the muscles around our skeleton and cause them to tense up to hold the weight we are not placing upon them. As the angles of these muscles change and their tension increases dramatically they will push against the nerves at the base of the neck and the arteries and veins exiting and entering the top of the rib cage (the Thoracic Outlet) thus causing Thoracic Outlet Syndrome.
The pain and numbness or tingling associated with TOS can be continuous or episodic in nature depending on the amount of pressure on the structures and they usually have a specific area that they stays within. Most commonly the symptoms are experienced in the hands but over time they may spread into the forearms and even up into the shoulders. People with TOS may also notice a decrease in sensation in the areas affects. If left for a long period of time without treatment muscle weakness can occur in the hand affected.
The exact areas of numbness and tingling and change in skin sensation will be different depending on if it is the nerves, arteries, or veins involved but in general the hand and forearm are the most common areas to experience these symptoms. These symptoms can be mimicked by other conditions such as Carpal Tunnel Syndrome, Herniated Intervertebral Discs in the neck (Cervical Spine), and even active trigger points in the rotator cuff muscles that can refer pain down into the hand and fingers. Make sure you see a doctor to determine the true cause of your pain.
When you go to a doctor they should ask a series of questions and perform a number of tests on you to help determine the nature and source of the problem. Thoracic Outlet Syndrome reacts very well to complementary treatments and therapies including chiropractic, acupuncture, massage, and physiotherapy all have excellent results.
Posture is an extremely important thing in our lives and if we maintain a good posture we can avoid conditions like TOS. So I hate to say it but our mothers were right, “Sit up straight and stop slouching.”
Thanks for reading,