Thoracic Outlet Syndrome
Post-traumatic thoracic outlet compression
syndrome (TOS). Theisler CW. Am J Chiro Med Dec 90;3(4):141-151
From
the abstract:
Thoracic outlet syndrome (TOS) results when the
brachial plexus and/or subclavian artery are compressed by
the muscles in the region of the first rib and artery. This
compression syndrome is characterized by pain in the head,
neck or upper extremities, paresthesia and/or vasomotor symptoms….non-operative,
conservative care, which includes manipulation and extensive
therapy, is the preferred choice of treatment.
Thoracic outlet
syndrome: diagnosis and conservative management. Liebenson,
CS Journal of Manipulative and Physiological Therapeutics,Vol.
11 No. 6, Dec 1988.
Thoracic outlet syndrome is caused by compression
or irritation of the nerves as they exit the neck toward the
upper extremity. Often it is the compression or irritation
of the brachial plexus, not from compression of the subclavian
artery.
In this discussion, the author notes some researchers
who believe that the sacroiliac plays a large role in the etiology
of this condition. Others feel an abnormal thoracic curve
is the cause.
The T4 syndrome. De Franca GG, Levine LJ Journal
of Manipulative and Physiological Therapeutics, Jan 1995, 18(1)
p34-7
Two cases of the T4 syndrome are discussed. Symptoms include
paresthesias, numbness, or upper extremity pains associated
with or without headaches and upper back stiffness. In addition,
no hard neurological signs are present.
Upper thoracic joint
dysfunction, especially in the region of the T4 segment, appeared
to be the major cause of the upper extremity symptoms and headaches.
A nontraumatic onset is common and the peculiar glove-like
distribution of hand or forearm pain can often lead to a mistaken
diagnosis, including psychogenesis.
Joint manipulation, stretching,
and strengthening exercises directed at the upper thoracic
dysfunctional segments were used with good results.
The role
of thoracic outlet syndrome in the double crush syndrome. Narakas
AO.. Annales de Chirurgie de la Main et du Membre Superieur,
1990, 9(5): 331-40.
The numb arm and hand. Bracker MD, Ralph
LP American Family Physician 51(1): 103-116, 1995.
Trauma and
compression along the course of the median, ulnar or radial
nerve from the brachial plexus to the fingers may cause pain,
weakness, numbness or tingling in the upper extremity. Diabetes,
smoking, alcohol consumption, rheumatoid arthritis and hypothyroidism
are risk factors for nerve entrapment although these disorders
typically produce bilateral symptoms.
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