Lifting the Veil on Thoracic Outlet Syndrome
By Dr. Molly Casey
Have you ever had tingling in your arms and hands or known someone who has? I bet you can think of someone! When this happens, people usually think the issue is in the hand, wrist, or shoulder. Often, it’s not. I always start with the spine in mind, then move farther down the extremities; I’m interested in treating the cause, not the symptom. Thoracic outlet syndrome is a perfect example of the symptom (tingling in the hand, for example) originating elsewhere on the body.
The thoracic spine is comprised of 12 vertebrae and is commonly thought of as the middle back. Chiropractic care is often synonymous with neck and low back pain, but few think of mid-back pain as the primary reason to seek chiropractic care. Basically, people often feel mid-back pain is simply something to live with. Yet this common upper thoracic condition can be debilitating for some people. Rest assured, there is no reason to continue to suffer the pins and needles from thoracic outlet syndrome; fortunately, chiropractic care can help.
Thoracic Outlet Syndrome
The 220 separate joints in the thoracic spine comprise the majority of the 313 separate joints of the entire spine. This section of the spine, often overlooked, is very important. A common dysfunction is in one of the communication systems between the spinal cord and upper extremities/upper thoracic spine. This communication system is called the brachial plexus. The condition is called thoracic outlet syndrome, TOS for short. TOS affects millions of people yearly.
The brachial plexus is a group of nerves and blood vessels located in the front of the neck, shoulder, and chest. This plexus can be easily compressed by ribs, collarbones, or associated muscles, resulting in TOS. Don’t let the name confuse you; though it does have to do with upper thoracic vertebrae and ribs, the cervical spine is often involved as well.
TOS Symptoms and Causes
When the brachial plexus is compressed, common symptoms include positional weakness of the arm, tingling and numbness of hands and fingers -- especially the fourth (ring) and fifth (pinky) digits -- difficulty grasping objects, swelling of the hands/arms, the sensation of coldness in the upper extremities, along with possible color changes.
Common underlying causes of TOS can be prior fractured or subluxated collarbones, extra ribs that are often called cervical ribs, sustained muscle tightness, and/or repetitive motions/positions of arms and upper thoracic spine while at work. Hairdressers frequently suffer from TOS due to the position of their arms at or above shoulder height for hours on end daily. Health practitioners will frequently confuse TOS with disc herniations, shoulder bursitis or even disorders of the elbow.
Chiropractors will examine the function and mobility of the cervical vertebrae, collarbones, upper ribs and upper thoracic spine. If there is misalignment or lack of proper motion (subluxation), the chiropractic adjustment can restore proper alignment and improve joint motion to help alleviate a portion of the cause.
Additional supportive care can be sought in the form of soft tissue (muscle) work and natural supplements that promote the anti-inflammatory process. Stretching and proper alignment at work with prolonged positions is imperative to healing and reduction of symptoms.
There’s no need to suffer from uncomfortable symptoms that ultimately are standing in the way of your health and wellness. Don’t ignore your thoracic spine or your brachial plexus, the doctors of chiropractic at The Joint certainly won’t!
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