Help for Thoracic Outlet Syndrome

Help for Thoracic Outlet Syndrome

Help for Thoracic Outlet Syndrome

I have a colleague that is dealing with Thoracic Outlet Syndrome (TOS). Her doctor has asked her to find someone who specializes on this condition. Just wonder if this is a condition that either of you have worked with? Please let me know if you have any recommendations.

Answer from Justine

First of all – ouch! TOS is no fun and is often called ‘sciatica of the shoulder girdle’. Here is a link to more information from one of my favorite resources, the Mayo Clinic:

You will see in reading it that there may be 2 sources of the problem – the neck where the brachial plexus nerves leave the spine, but also the thoracic outlet itself in the shoulder under the collar bone. She may get relief by focusing on both areas. In my experience (which is obviously limited to the amount of people I can see) is that it is usually neurogenic as opposed to vascular. You can inquire with your colleague to get more about her symptoms, look at the coloring in her hand and check the strength of her pulse on the effected arm. I find even with the neurogenic type, it does not always originate at the neck, but may be due to tight pecs – particularly pec minor, causing compression of the nerves as they travel through the thoracic outlet.

Here are some ideas:

  • Check the alignment of her neck – work on axial extension and balancing the cervical curve (Jalandhara bandha would be useful here). If she is kyphotic in her thoracic spine, be sure to address that as well through axial extension, opening the chest muscles and strengthening the rhomboids.
  • Be very mindful of back bends, possibly avoid them in the upper back and neck or keep chin tucked – back bends can compress the back of the spine where the nerve roots come out and could shorten/compress the area around the thoracic outlet.
  • Work on opening the chest, particularly pec minor – hand on the wall at a 135 degree from the body, start to turn the opposite shoulder away until a stretch is felt, look away from wall and drop chin down, breathe into the sensation of stretch – deepening the breath will increase the stretch.

Poses to open the musculature around the neck. Here are some ideas:

  • The first video below is great for alternately stretching and contracting the neck muscles to release tension.
  • For the second video below start around the 4:25 mark.
  • The third video is for releasing fascia in the neck and arm.
  • Garshana (body brushing) and Abhyanga (body oiling) would also be very helpful for nourishing the tissue and calming the nerves I attached an informational sheet on how to do it 🙂
  • A therapeutic massage with someone well trained would be lovely for her…..if not comfortable while doing it, relief should come afterwards.  I would also suggest Cranial Sacral Therapy as an option for her.

I hope that helps! Please feel free to reach out with more questions and a progress report on how she is doing.