Thoracic outlet syndrome is a group of disorders where blood vessels or nerves in the space between the collarbone and the first rib (the thoracic outlet) are compressed. This will cause pain in the neck and shoulders along with numbness down the arm, hand, and fingers. A lot can cause thoracic outlet syndrome and the causes can vary such as a car accident injury, repetitive job injury or sports related injuries, anatomical defects such as an extra rib, poor posture and pregnancy. Treatments for this include Physical Therapy and Pain Management. In severe cases, doctors may suggest surgery.
Thoracic outlet syndrome is usually broken up into two different categories. The first is neurogenic thoracic outlet syndrome. This type will be compression of the brachial plexus and this plexus controls movements and sensations in your shoulders, arms and hands. The second type is vascular thoracic outlet syndrome and it occurs when one or more veins (venous thoracic outlet syndrome) or arteries (arterial thoracic outlet syndrome) under the collarbone are compressed. Signs of the neurological thoracic outlet syndrome are numbness and tingling in the arm and hand on the affected side, pain and aches in the neck, shoulders or hands, and a weakened grip. The vascular type has a lot more signs. They will include discoloration of the hand or lack of color in one or more of the fingers, arm pain and swelling possibly due to a blood clot, weak or no pulse on the affected side, cold fingers, arm and hands, weakness, numbness and/or throbbing pain.
Now that we know a little bit more about thoracic outlet syndrome let's talk about how massage therapy can help. When you first are with your therapist and you have concerns or diagnosis of this, they'll do some testing. There are several different types of muscle testing that the therapist will do to determine how the treatment will go. We need to be able to distinguish where the compression is coming from to be able to better target and help the issue. If the compression is coming from the neck or the shoulder, all of this information will help us coordinate our treatment plan and better serve your situation.
Now that they know exactly where to get started, there are few key techniques therapists will do. Neuromuscular therapy or trigger point therapy will eliminate the trigger points in the muscles of the front of the neck or shoulder that could be causing the compression. Myofascial release or deep tissue massage will help release fascial adhesions in the thoracic outlet and in the surrounding tissues. Neuromuscular therapy will help stretch and loosen the muscles of the thoracic outlet and postural release will help stretch the muscles in and around the affected area. The therapist should do the same muscle testing again after the treatment to make sure that there was some relief in pain and improved range of motion. The first visit may not show much of a difference. If you are having an acute flare up, you should be seen at least once a week.. Your therapist should give you some stretches/homework to do in between sessions. Each session will begin with the same muscle testing to assess for reduced movements and pain, or improvements.
Having continuous pain and numbness that is caused by this can be quite frustrating. If you follow Physical Therapy and Massage Therapy plans, you should be able to overcome the pain and have relief in some weeks. As always, consult with your doctors before getting these treatments and bring along any helpful information from doctors or your Physical Therapist.