Thoracic outlet syndrome is a group of disorders due to compression of blood vessels or nerves, between the clavicle, first rib, or cervical vertebral nerve roots. Specifically, the brachial neural plexus, subclavian artery, subclavian vein, or any combination of these can be constricted.
TOS can be acute or with gradual onset and there are three major types: arterial, venous, or neurogenic. Neurogenic TOS accounts for 97% of TOS cases. Up to 80% of TOS patients have a history of trauma to the cervical spine or shoulder. Neurogenic TOS manifests with pain numbness tingling weakness and vasomotor changes. Conservative management requires careful and exhaustive history and physical examinations along with selective diagnostic testing. It is important to also evaluate areas of the neck shoulders for muscle spasm, weakness, and hypoesthesia in specific nerve distributions.
This is extremely important to find a management team who regularly treats patients with TOS to have an accurate view of the disorder its treatment in the possible success rate.
As a sports chiropractor, I'm dedicated to staying current on the latest research and management strategies for complicated conditions like neurogenic thoracic outlet syndrome (NTOS).
The significance of therapeutic exercise rehabilitation in the management of NTOS is highlighted by recent studies, such as "Physical therapy management of thoracic outlet syndrome: A systematic review of practice patterns and interventions" by MacDonald et al. (2019) and "Thoracic Outlet Syndrome Rehabilitation: A Systematic Review and Meta-Analysis" by Chaitow et al. (2019).
These studies highlight the requirement for a multimodal strategy, integrating several interventions for the best results.
The case study "A multimodal approach to the management of neurogenic thoracic outlet syndrome in a collegiate swimmer: a case report" by Tamer et al. (2021) provides an example of this method using a collegiate swimmer.
The patient had NTOS symptoms, such as tingling and numbness in her hand and arm, which were impairing her ability to perform.
The course of treatment included patient education, chiropractic adjustments, and therapeutic exercise rehabilitation. The therapeutic exercise program targeted the muscles involved in the thoracic outlet with flexibility, strengthening, and postural exercises.
In order to address any spine or rib biomechanical dysfunctions, the patient received chiropractic adjustments. The patient reported a significant improvement in her symptoms and performance following the multimodal treatment approach, which suggested favorably for the case study's outcomes.
This emphasizes the significance of treatment NTOS holistically, taking into account both the neurogenic and musculoskeletal aspects of the disease.
According to "Neurogenic Thoracic Outlet Syndrome: Exercise Prescription and Patient Education" by Cipriani et al. (2018), patient education is essential for addressing NTOS in addition to therapeutic exercise therapy.
Patients can better control their symptoms and avoid recurrences by gaining education about ergonomics, posture, and lifestyle changes.
When treating patients with NTOS, as a sports chiropractor, I use these most recent advancements and evidence-based techniques in my practice. A comprehensive evaluation that includes a thorough history, physical exam, and imaging tests enables me to pinpoint the underlying causes and create a treatment strategy that is specific to the patient.
In a nutshell NTOS is a complex disorder that needs to be managed well using a multimodal strategy. Recent studies have shown the value of patient education, chiropractic adjustments, and therapeutic exercise rehabilitation in treating the neurogenic and musculoskeletal aspects of NTOS.
I am able to offer complete therapy to my patients, assisting them in overcoming NTOS and returning to their active lifestyles, by keeping up to speed on the most recent research and implementing evidence-based protocols.
Consult with a competent sports chiropractor for a precise diagnosis and a customized treatment plan if you believe you may have NTOS.
Want to learn more about effective therapeutic exercise rehab for NTOS? Follow us for the latest updates and evidence-based protocols to stay ahead in managing NTOS and optimizing your performance!
Stay active, stay healthy!
Dr. Tim
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