Thoracic Outlet Syndrome

Our professional use of shockwave therapy and neuromuscular therapy quickly resolves nerve compression syndromes, such as thoracic outlet syndrome. Most see the condition completely resolved in 2-3 treatments.

Thoracic outlet syndrome is a condition where either the nerves, artery and/or vein which supply your arm, becomes entrapped, or squeezed to some extent. It is a very common condition responsible for so many symptoms that many of us will experience on a semi-regular basis. It can be considered a repetitive strain condition like that of a tendonitis but involves the muscles and connective tissue fascia of those muscles.

Symptoms:
Since three different structures may be involved, we will break down the symptoms associated with each. Keep in mind that you may experience symptoms from one, two or from all three structures being squeezed.

Nerve compression symptoms:

  • Pins /needles/numbness sensations into the elbow, hand and/or fingers.
  • Nagging ache into your shoulder, shoulder blade, elbow, wrist and/or hand.
  • Deep pain in your chest which is often confused with the pains of a heart attack.
  • Sharp-shooting sensations into your shoulder blade, shoulder, elbow and/or hand.
  • Weakness into your hands, with a tendency to drop things.

Artery Compression Symptoms:

  • Sensations of cool or cool fingers.
  • Weakness in the hands.
  • Bluish or pale color in the skin of the lower arm and hands.
  • Pins and needles sensations into the fingertips.

Vein compression symptoms:

  • Bluish color into the fingertips.
  • Swollen forearm, and/or hand.
  • Hot feeling into your hand itchy forearm and/or hand

Causes:
Thoracic outlet syndrome develops when a muscle or group of muscles anywhere this neurovascular bundle travels, becomes fibrotically hardened and inelastic. Most muscles can develop a fibrotic condition and not affect any nearby nerves or arteries, but it is where this particular bundle travels that makes it susceptible to compression.

We use our arms repeatedly all day long, in motions that can't be achieved anywhere else in our body. Your shoulder allows for an amazing range of motion of the arm. this huge range along with the work we do with it every day places stresses on the very muscles that provide this movement. At any time we can develop an overused muscle which over time can either resolve or worsen depending on the activity which first caused the overuse. A compression can occur if one of the many muscles which is close to, or wrapped around this bundle becomes fibrotic.

Here is a partial list of those who are potentially at increased risk of developing thoracic outlet syndrome.

  • Overly tall people
  • Those who use their arms in a pulling action repeatedly
  • Smokers
  • Those who suffer from stress
  • Those who work on computers or prolonged desk work
  • Those with COPD (asthma, emphysema)
  • Those who cough repeatedly as with a lingering flue or pneumonia
  • Hairdressers
  • Landscape labourers

What Really Is Happening?
All of the nerves, arteries and veins which supply your arm, begin in your neck. They travel down from your neck all the way to your fingertips together in a bundle called a neurovascular bundle. This bundle of nerve, arteries and veins must be capable of gliding freely in the sleeve they travel in. Whether you reach backwards with an outstretched arm, or simply reach to comb your hair, this bundle must be allowed to glide in its sleeve. If a compression occurs anywhere along the path of the bundle, then you will experience symptoms typical of what is being squeezed in the bundle at that location.

Although this bundle travels deep close to the bones of your skeleton, protected by the muscles above it, dysfunctional muscle fibres can still compress it. Most compressions however, occur where this bundle changes direction. Below are those locations.

  • Side of your neck
  • Where your throat meets your collar bone
  • Where your collar bone meets your shoulder
  • Your armpit
  • Your elbow
  • Your wrist

When a muscle is overused it can develop a fibrotic arrangement in its fibres, which causes the muscle to become short, inelastic, and somewhat hardened like the gristle on a roast beef. If this condition develops close to this neurovascular bundle, the muscular fibrosis can actually form close to, or even around the bundle. Over time if this muscular dysfunction worsens, it can slowly begin squeezing the bundle. If only the nerves in the bundle are squeezed, then your symptoms will be of those common to the nerve being squeezed. In the most severest of cases, all three structures in the bundle may be squeezed and your symptoms will be numerous and serious. It is however, an easy condition to treat.

What Treatments Consist Of
Basically, we must remove the inelastic fibrotic fibres of the affected muscles along the neurovascular bundles travels. The three locations to consider are in the neck, chest and upper arm. Additional locations may exist in the elbow, wrist as well.  We utilize our shockwave/therapeutic massage therapy protocol to get the job done.

     

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