Thoracic Outlet Syndrome: What It Is, How to Fix It

By Dr. Molly Casey

Thoracic Outlet and You

Sometimes there are big terms in the healthcare field that can be quite scary. Add that fear to the symptoms and side effects of the actual issue and you’ve got a concoction for a whole lot of confusion. This confusion makes it even harder to understand what’s really going on and the best course of action to rectify. When one looks to use as much conservative and natural approaches in their healthcare, in confusing situations it can feel harder to go the natural route. Thoracic outlet syndrome, or TOS, is just one such case.

Thoracic Outlet Anatomy

The thoracic outlet is a space near the bottom of the neck and the top of the shoulder. The ring shaped space is found between the clavicle (collar bone), the first rib and various lower cervical (neck) muscles. Through this space runs the brachial plexus. A plexus is a bundle or network of nerves or vessels. The brachial plexus is made of nerves that control the movements and feelings in the shoulder, arm and hands. There are also blood vessels that run through this space.

Thoracic Outlet Syndrome

Thoracic outlet syndrome is a diagnosis given when the brachial plexus and/or associated blood vessels have been compressed by the surrounding structures. The compression can occur because of a variety of reasons. It can be caused directly by a misaligned or restricted range of motion of the first rib or clavicle. Indirect causes can be the motion of the lower cervical and upper thoracic vertebrae. The tightness of the cervical muscles can contribute to the compression as well.

Symptoms of TOS vary depending on the structures involved in the compression. Symptoms are categorized by either neurogenic versus vascular. Neurogenic (originating from the compression of nerves) can be pain or numbness/tingling in your neck, shoulders and/or hands, weakening of the hand grip, and/or muscles wasting of the fleshy base of the thumb. Vascular (blood vessel) compression symptoms can include discoloration of your hand, pain in your arm and hand, weak or no pulse in lower portion of forearm, weakness of neck and arm, as well as fatigue in the upper extremity.

Can Chiropractic Help?

Yes, chiropractic adjustments can help thoracic outlet syndrome. The correction of cervical misalignment or restriction in range of motion through the chiropractic adjustment helps foster and promote full and proper function of the structures that create the outlet.

Doctors of chiropractic can manipulate both the first rib and the clavicle to allow for proper alignment and range of motion for both of those structures. This then creates more space for the nerves and blood vessels within the outlet promoting greater function and decreasing symptoms. Chiropractors can also give you stretches and strengthening options to help correct the associated musculature tightness and/or weakness that may be contributing to the issue.

The truth is that this can be quite scary. The truth also is that there is conservative care that can help you. If you find yourself having the symptoms or diagnosis of thoracic outlet syndrome, come into The Joint Chiropractic and let us see if we can help you help yourself in the most conservative manner that corrects the issue at the root of the problem.

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