Topics > Shoulder > Thoracic Outlet Syndrome
Thoracic Outlet Syndrome
The thoracic outlet is a space between the rib cage (thorax), and
the collarbone (clavicle) through which the main blood vessels and nerves
pass from the neck and thorax into the arm. Thoracic outlet syndrome
is a combination of pain, numbness, tingling, weakness, or coldness in
the upper extremity caused by pressure on the nerves and/or blood vessels
in the thoracic outlet. In some cases, the cause of compression is evident
such as an extra first rib or an old fracture of the clavicle, which
reduces the space of the outlet. Sometimes, if the shoulder muscles in
your chest are not strong enough to hold the collarbone in place, it
can slip down and forward, putting pressure on the nerves and blood vessels
that lie under it. Poor posture or obesity also may contribute to the
cause. Compression may also occur with repetitive activities that require
the arms to be held overhead. In other cases, the cause is not clear.
Depending
on the extent of compression, symptoms vary. Reduced pressure to the
arms with compression makes ones arms feel cool and easily fatigable.
Pressure on the nerves causes a vague aching pain in the neck, shoulder,
arm and hand.
The treatment for thoracic outlet syndrome is usually symptomatic
including analgesics and physical therapy to increase range of motion
of the neck
and shoulders, strengthen muscles, and induce better posture. For most,
prognosis for recovery is good. Surgery is usually not required unless
there is an obvious compression, particularly by a bone.
The following simple exercises are recommended if you have thoracic
outlet syndrome to strengthen your shoulder muscles. Try to do 10
repetitions of each exercise twice daily. However, if you experience
any pain with
the exercise recommendations, you should stop.
- Corner Stretch: stand
in a corner (about one foot away from the corner) with your hands
at shoulder height, one on each wall. Lean
into the corner
until you feel a gentle stretch across your chest. Hold for 5 seconds.
- Neck Stretch: put your left hand on your head, and your right hand
behind your back. Pull your head toward your left shoulder
until you
feel a gentle
stretch on the right side of your neck. Hold for 5 seconds.
Switch hand positions and repeat the exercise in the opposite direction.
- Shoulder
Rolls: shrug your shoulders up, back, and then down in a circular motion.
- Neck
Retraction: pull your head straight back, keeping your jaw level.
Hold for 5 seconds.
