Thoracic outlet syndrome treatment
Thoracic outlet syndrome (TOS) is a broad group of diseases characterized by compression of the neurovascular bundle by bones, ligaments, or muscles. The condition occurs as a result of injury, congenital anomaly, or illness. Treatment for thoracic outlet syndrome begins with physical therapy and rehabilitation. Sometimes, a doctor may suggest surgery.
Thoracic outlet syndrome is a complex of symptoms when squeezing the nerves and blood vessels in the area between the clavicle and the rib (thoracic outlet). The pathology has no age preference. However, this disorder is more common in athletes. In addition, women are more than three times more likely to suffer from thoracic opening syndrome than men.
Doctors classify TOS as follows:
- Neurogenic (95% of cases) occurs with brachial plexus compression.
- Venous (2-5%) - characterized by squeezing the vein, which may cause thrombosis.
- Arterial (approximately 1%) - described as compression of an artery. It is a risk factor for arterial aneurysm formation.
Symptoms vary depending on whether the nerve or blood vessel is compressed.
- Nerve compression: pain in the neck, shoulder, arm, or hand; weakness, numbness, or tingling of the hands and fingers
- A squeeze of blood vessels: swelling and redness or whiteness of the arm; weakness in the arm, difficulty in raising the arms.
The main stage of the disease is to make the correct diagnosis quickly. Evaluation of the patient's condition includes a physical examination by a traumatologist, neurosurgeon and neurologist. Duplex ultrasound and chest CT/MRI scans are the most effective and commonly used methods. Sometimes a neurologist might perform a nerve conduction study to check for nerve function and order angiography (in the case of vascular compression).
Treatment options for thoracic outlet syndrome depend on whether the condition is neurogenic or vascular. Neurogenic TOS is treated with botulinum toxin injections or surgery if necessary. For venous and arterial thoracic outlet syndrome, physicians recommend drugs for the resorption of blood clots and surgical intervention (balloon angioplasty or arterial reconstruction). Rehabilitation and physical therapy are essential treatments for all types of TOS as an additional but necessary step.
In general, the prognosis for people with thoracic outlet syndrome is good. Most cases resolve after rehabilitation exercises. However, up to 20% of patients with this disorder require surgical treatment. In more than 95% of patients with arterial TOS, surgery eliminates the symptoms of the disease.