Thoracic Outlet Syndrome Explained

Thoracic Outlet Syndrome: How is it Defined?

Thoracic outlet syndrome (TOS) can be defined as a compression of the neurovascular bundle as it passes between the neck and axilla. Common compression points are between the anterior and middle scalene, between the first rib and clavicle, underneath the pectoralis minor, or potentially the presence of an extra cervical rib. Patients with thoracic outlet syndrome typically present with forward, rounded shoulders and a history of repetitive overhead motion. Both the neural and vascular structures can become compromised, but >95% of all cases are neurogenic. If you are suspecting a patient with neurogenic TOS cluster your TOS tests results with other neuro-dynamic tests.

TOS Explained by Dr. Robert Thompson at Washington University in St. Louis

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How I Treat Neurogenic TOS: A Case Study Example

Each individual case will have slight variations, but the examination section will be similar for each person

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My Personal Experience with Venous TOS

In 2010, my entire right arm started to swell. I went to the doctor and initially was prescribed antibiotics for MRSA. I had been paint-balling 2 days prior to the incident and had a few open wounds that were potentially infected. The doctor said to follow up in a few days if I did not improve. My arm continued to swell and became even worse with activity. At the second visit, I was told to go to the hospital to get a venous doppler for a suspect DVT. The doppler revealed a ~4 inch blood clot in my subclavian vein. I was immediately admitted to the ER, placed on blood thinners, and underwent a surgical procedure to remove the clot. CLICK BELOW TO CONTINUE READING

Click here to read about Jim Heafner's First Rib Resection

-Jim Heafner PT, DPT, OCS

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