THORACIC OUTLET SYNDROME (TOS)
THORACIC OUTLET SYNDROME IS A TERM THAT DESCRIBES A GROUP OF PATHOLOGICAL CONDITIONS THAT ARE LOCALIZED AROUND THE TOP OF THE CHEST CAVITY ABOVE THE FIRST RIB. this anatomic location is called THE THORACIC OUTLET. THE SUBCLAVIAN ARTERY, SUBCLAVIAN VEIN AND NERVES OF THE BRACHIAL PLEXUS CAN BE INVOLVED. THESE PATIENTS PRESENT WITH COMPLAINTS OF PAIN, NUMBNESS, TINGLING AND WEAKNESS INVOLVING THE ARMS. THE CAUSE OF THESE SYMPTOMS FROM THORACIC OUTLET SYNDROME IS PRESSURE AGAINST THE NERVES AND/OR BLOOD VESSELS THAT GO TO THE ARM.
THE GROUP OF NERVES THAT BEGIN IN THE CERVICAL SPINE AND GO TO THE ARM IS CALLED THE BRACHIAL PLEXUS. NEUROGENIC THORACIC OUTLET SYNDROME IS WHEN THE PRESSURE IS ON THE BRACHIAL PLEXUS NERVES. NEUROGENIC THORACIC OUTLET SYNDROME COMMONLY PRESENTS WITH ARM COMPLAINTS OF PAIN, NUMBNESS, TINGLING AND WEAKNESS. NEUROGENIC THORACIC OUTLET SYNDROME CAN BE TREATED WITH ACUPUNCTURE AND IS THE ONLY TYPE OF THORACIC OUTLET SYNDROME THAT WILL BE DISCUSSED. the brachial plexus can be injured of be dysfunctional without any pressure causing the nerve dysfunction. I will separately discuss the brachial plexus later.
SOME PATIENTS ARE BORN WITH AN EXTRA RIB ABOVE THE FIRST RIB WHICH NARROWS THE THORACIC OUTLET AND THESE PATIENTS HAVE A HIGHER PROBABILITY THAT THEY WILL develop THORACIC OUTLET SYNDROME.
AFTER A TRAUMATIC EVENT, LIKE A CAR ACCIDENT, THE SCALENE MUSCLES IN THE NECK WHICH SURROUND THE BRACHIAL PLEXUS AND THE SUBCLAVIAN VESSELS MAY GO INTO SPASM OR MAY BLEED. PRESSURE OF TENSE MUSCLES MAY PERSIST OR SCAR TISSUE MAY FORM IN THE COURSE OF HEALING THE INJURED TISSUES.
THE PRESSURE OF THE SCAR CAUSES PAIN OR DYSFUNCTION OF THE NERVES OF THE BRACHIAL PLEXUS. SCAR TISSUE PRESSING ON THE SUBCLAVIAN VESSELS UPSETS THE BLOOD FLOW IN THESE VESSELS. IN THE PAST I PERFORMED MANY OPERATIONS FOR THIS CONDITION. removing a rib, CUTTING MUSCLE OR SCAR TISSUE WOULD SOMETIMES SIGNIFICANTLY RELIEVE THE PAIN, NUMBNESS, TINGLING OR WEAKNESS. OTHER TIMES THE OPERATION WAS NOT HELPFUL BECAUSE THE MODE OF INJURY WAS A STRETCH INJURY OR THE NERVE WAS DAMAGED BY THE LONG TIME OF COMPRESSION AND DID NOT RECOVER NORMALLY.
THORACIC OUTLET SYNDROME IS ONE OF THE FIRST CONDITIONS THAT I HAD CONSIDERABLE EXPERIENCE TREATING SUCCESSFULLY WITH ACUPUNCTURE. THE PATIENTS WHO WERE REFERRED TO THE OFFICE WITH THIS CONDITION FOR OPERATION OR ANESTHETIC INJECTION WERE INSTEAD TREATED WITH ACUPUNCTURE.
THE GROUP OF NERVES THAT BEGIN IN THE CERVICAL SPINE AND GO TO THE ARM IS CALLED THE BRACHIAL PLEXUS. NEUROGENIC THORACIC OUTLET SYNDROME IS WHEN THE PRESSURE IS ON THE BRACHIAL PLEXUS NERVES. NEUROGENIC THORACIC OUTLET SYNDROME COMMONLY PRESENTS WITH ARM COMPLAINTS OF PAIN, NUMBNESS, TINGLING AND WEAKNESS. NEUROGENIC THORACIC OUTLET SYNDROME CAN BE TREATED WITH ACUPUNCTURE AND IS THE ONLY TYPE OF THORACIC OUTLET SYNDROME THAT WILL BE DISCUSSED. the brachial plexus can be injured of be dysfunctional without any pressure causing the nerve dysfunction. I will separately discuss the brachial plexus later.
SOME PATIENTS ARE BORN WITH AN EXTRA RIB ABOVE THE FIRST RIB WHICH NARROWS THE THORACIC OUTLET AND THESE PATIENTS HAVE A HIGHER PROBABILITY THAT THEY WILL develop THORACIC OUTLET SYNDROME.
AFTER A TRAUMATIC EVENT, LIKE A CAR ACCIDENT, THE SCALENE MUSCLES IN THE NECK WHICH SURROUND THE BRACHIAL PLEXUS AND THE SUBCLAVIAN VESSELS MAY GO INTO SPASM OR MAY BLEED. PRESSURE OF TENSE MUSCLES MAY PERSIST OR SCAR TISSUE MAY FORM IN THE COURSE OF HEALING THE INJURED TISSUES.
THE PRESSURE OF THE SCAR CAUSES PAIN OR DYSFUNCTION OF THE NERVES OF THE BRACHIAL PLEXUS. SCAR TISSUE PRESSING ON THE SUBCLAVIAN VESSELS UPSETS THE BLOOD FLOW IN THESE VESSELS. IN THE PAST I PERFORMED MANY OPERATIONS FOR THIS CONDITION. removing a rib, CUTTING MUSCLE OR SCAR TISSUE WOULD SOMETIMES SIGNIFICANTLY RELIEVE THE PAIN, NUMBNESS, TINGLING OR WEAKNESS. OTHER TIMES THE OPERATION WAS NOT HELPFUL BECAUSE THE MODE OF INJURY WAS A STRETCH INJURY OR THE NERVE WAS DAMAGED BY THE LONG TIME OF COMPRESSION AND DID NOT RECOVER NORMALLY.
THORACIC OUTLET SYNDROME IS ONE OF THE FIRST CONDITIONS THAT I HAD CONSIDERABLE EXPERIENCE TREATING SUCCESSFULLY WITH ACUPUNCTURE. THE PATIENTS WHO WERE REFERRED TO THE OFFICE WITH THIS CONDITION FOR OPERATION OR ANESTHETIC INJECTION WERE INSTEAD TREATED WITH ACUPUNCTURE.
