Thoracic Outlet Syndrome, aka TOS, is a rare condition that involves pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collar bone. The cause of TOS can be due to several factors and depending on which anatomical structures are compressed: arteries, veins, or nerves. Compression can be of different magnitude in each of these structures. Therefore symptoms can be protean.
Due to involvement of the medial cord of the brachial plexus, the ulnar nerve is most impacted by this compression syndrome. Muscles affected will be the Flexor Carpi Ulnaris. As a result, there can be pain, altered sensation, and muscle wasting on the ulnar aspect of the forearm, hand and possibly fingers. Compression of blood vessels may result in pain, paleness of the skin, and decreased skin temperature. Prolonged decrease of blood supply can result in trophic skin changes, emboli (blood clots) and gangrene. Compression of a vein will result in edema.
There are 4 main areas where compression may occur: 1)The anterior and middle scalene (aka the interscalene triangle). The brachial plexus and subclavian artery pass through here, but it is the medial cord of the plexus, arising from the C8-T1 nerve roots, that is most likely affected. 2) Pectoralis minor - hypertonicity of this muscle will compression the subclavian artery as it becomes the axillary artery when it passes through the clavicle. 3) Costoclavicular - compression occurs between the 1st rib and the clavicle. This is usually due to a clavicle break or dislocation, and is prone to affect the vasculature, as the axillary vein becomes the subclavian vein. 4) Presence of a cervical rib - the presence of an extra rib is determined by an x-ray, and it interferes with the size of the interscalene triangle, therefore allowing less room for the plexus and vasculature.
Thoracic Outlet Syndrome usually affects people whose posture tends to be very forward and slumping. Think of a person who sits at a desk all day, or who does a lot of work moving forward (massage therapist and dentist). Others who are also at risk are people with "military posture". Such posture causes extreme retraction of the shoulders which pull the pectorialis minor tight over the plexus and artery, thus compressing it.
Chiropractic care can provide valuable assistance to someone suffering from TOS, either as a stand-alone treatment, or in conjunction with other modalities. Since it is subluxations (misalignments of the spine) that may cause reduced spinal nerve flow, the person who might be able to help is someone who has been trained to locate and treat your spinal subluxations: your chiropractic doctor. Once these misalignments have been identified, chiropractic care can realign the misplaced vertebrae and allow normal nerve function to occur again.
Due to involvement of the medial cord of the brachial plexus, the ulnar nerve is most impacted by this compression syndrome. Muscles affected will be the Flexor Carpi Ulnaris. As a result, there can be pain, altered sensation, and muscle wasting on the ulnar aspect of the forearm, hand and possibly fingers. Compression of blood vessels may result in pain, paleness of the skin, and decreased skin temperature. Prolonged decrease of blood supply can result in trophic skin changes, emboli (blood clots) and gangrene. Compression of a vein will result in edema.
There are 4 main areas where compression may occur: 1)The anterior and middle scalene (aka the interscalene triangle). The brachial plexus and subclavian artery pass through here, but it is the medial cord of the plexus, arising from the C8-T1 nerve roots, that is most likely affected. 2) Pectoralis minor - hypertonicity of this muscle will compression the subclavian artery as it becomes the axillary artery when it passes through the clavicle. 3) Costoclavicular - compression occurs between the 1st rib and the clavicle. This is usually due to a clavicle break or dislocation, and is prone to affect the vasculature, as the axillary vein becomes the subclavian vein. 4) Presence of a cervical rib - the presence of an extra rib is determined by an x-ray, and it interferes with the size of the interscalene triangle, therefore allowing less room for the plexus and vasculature.
Thoracic Outlet Syndrome usually affects people whose posture tends to be very forward and slumping. Think of a person who sits at a desk all day, or who does a lot of work moving forward (massage therapist and dentist). Others who are also at risk are people with "military posture". Such posture causes extreme retraction of the shoulders which pull the pectorialis minor tight over the plexus and artery, thus compressing it.
Chiropractic care can provide valuable assistance to someone suffering from TOS, either as a stand-alone treatment, or in conjunction with other modalities. Since it is subluxations (misalignments of the spine) that may cause reduced spinal nerve flow, the person who might be able to help is someone who has been trained to locate and treat your spinal subluxations: your chiropractic doctor. Once these misalignments have been identified, chiropractic care can realign the misplaced vertebrae and allow normal nerve function to occur again.
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