Thoracic outlet syndrome & Alternative to surgery

Q: My husband has had arm pain and tingling in his hand sporadically for over a year. His doctor mentioned something about a pinched nerve or blood vessel and suggested surgically removing a rib as a treatment. Are there any alternatives to surgery that you can recommend? Would chiropractic and/or physical therapy help?

A: It sounds like the condition your husband suffers from is Thoracic Outlet Syndrome (TOS). This involves a pinching of the nerves and blood vessels under the collar bone (clavicle) and arm.

Chiropractors and physical therapists have worked successfully to correct thoracic outlet syndrome. However, not all cases can be resolved by such conservative therapy. Nevertheless, it makes sense to give it a try before resorting to surgery, which is irreversible and carries with it more risk than less invasive treatment options.

Thoracic outlet syndrome can develop from a variety of causes. Your chiropractor or therapist will need to ascertain the cause in order to design a plan of correction. Possible causes include:

  • A drooping shoulder – as is often the case with poor posture where sagging shoulders cause the collar bone to pinch nerves and blood vessels travelling to the arm.
  • Fracture of the first rib or collar bone.
  • Spasms or over-development of certain neck muscles.
  • Misalignment (subluxation) of the neck or upper back bones. For example, working with your arms overhead can strain muscles that tug these bones out of their normal position, causing nerves and blood vessels to be compromised.

     Symptoms of thoracic outlet syndrome may include:

  • Neck, shoulder, arm and/or hand pain.
  • Tingling or numbness of the hand, arm or neck.
  • Muscle weakness of the arm and/or hand.
  • Hot and cold sensations of the arm and/or hand (due to improper blood flow)
  • Swelling around the neck and shoulder area.