Tuesday, March 22, 2011

Radiating Pain Due To Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) generally affects woman more than it would men. It occurs most often in the 35 to 55 age group. Thoracic outlet syndrome has to be differentiated from other conditions that may simulate the symptoms found in this condition. Thoracic outlet syndrome can be attributed to two different categories, neurogenic or vascular. Neurogenic, possibly the most prevalent is due to entrapment of nerves and can be due to various causes. The vascular type is due to obstruction of blood vessels emanating in the neck, shoulder, armpit (axilla), and upper arm.

Neurogenic thoracic outlet syndrome (NTOS) can be due to a congenital condition or a trauma to the neck or shoulder. A trauma such as a whiplash injury sustained in an automobile accident or a severe fall, or an injury sustained in contact sports can be such a causative factor. Any such trauma can affect the cervical spine or muscles, tendons and ligaments in the neck and shoulder. Any individual displaying neurogenic (nerve) or vascular (circulatory) symptoms should consult a Chiropractor or Physician for a comprehensive examination. His/her examination will include various orthopedic tests, x-rays, and possibly an MRI if indicated. There may also be other tests, such as an EMG to evaluate the normal function of the nerves.

The nerves that will be affected are the 8th cervical (C8) to the 1st thoracic (T1) found in the base of the neck and the spine, between the shoulder blades (scapulae). The nerves can be compressed or tractioned (pulled) at several sites, due to a variety of reasons. A congenital condition such as "cervical ribs" may be causing pressure on nerves or blood vessels. A cervical rib is an enlargement, or an overgrowth of the transverse processes of the 7th cervical vertebra or 1st thoracic vertebra. If the cervical rib is abnormally enlarged, surgical intervention may be necessary. If the patient can obtain relief with other treatment methods, that of course would be the best course to adopt.

Neurogenic thoracic outlet syndrome (NTOS) will present such symptoms as pain, numbness and tingling (neurasthenia) in the neck, with pain, numbness and tingling radiating into the armpit (axilla), upper arm, forearm and hand. The fingers are also involved and usually affect the 4th and 5th, or the 1st and 3rd fingers. As the condition progresses there will develop a weakness in the arm and hand. Further progression will cause atrophy of the muscles and a greater weakness, interfering with the normal use of the arm, hand and fingers.

Vascular thoracic outlet syndrome (VTOS) will affect the blood vessels in the neck, shoulder, armpit, arm, forearm and hand. The vessels that are usually affected are the subclavian or the brachial plexus. Any compression of these vessels, whether due to bone, muscle, inflammation, or scar tissue will cause an impairment of the circulation. The vascular changes will be most apparent in the hand. There will be loss of circulation causing a blanching (cyanosis) and swelling. Severe cases can cause a condition known as "Raynaud's phenomenom. Raynaud's phenomenom generally causes a burning sensation in the hand. The blanching occurs intermittently and is usually triggered by cold. Usually Raynaud's is secondary to thoracic outlet syndrome. If left untreated a rare result may occur that will result in a distal gangrene.

On rare occasions, another class of symptoms may occur. When the subclavian artery is blocked near the origin of the vertebral artery, there can occur a reverse blood flow to the brain causing cerebrovascular symptoms. This is not the usual thoracic outlet syndrome we are discussing at this time. This is another condition that is due to the correlation of pressure on the subclavian artery.

Thoracic outlet syndrome, like any other condition that affects the nerves, muscles and blood vessels, needs to be treated as soon as symptoms become apparent. Visiting their Chiropractor or physician as stated earlier in this article, should be their first order of business. In most instances the Chiropractor is best suited to treat the nerve impingement that is certainly present. He/she will find the cause of impingement and treat the patient to remove the causative factor. He/she will also treat the patient with adjunctive therapies, such as, electric muscle stimulation, ultrasound, trigger point massage therapy and diathermy,

The patient will generally respond well to this therapy and Chiropractic treatment. However, it is up to the patient to help in their treatment. With home healthcare, they will speed their recovery while alleviating the pain that will be ongoing as they receive treatment from their Chiropractor or their Physician. Using a good analgesic gel can relieve pain and muscle spasms. The use of a vibrator that has hot or cold can add to therapy adjuncts and. can be very soothing. The alternate use of hot and cold in conjunction with the vibration will also be beneficial in increasing circulation and removing toxins from the muscles. It will also relieve the spasms that may be present. Maintaining an exercise program, will prevent muscle atrophy, keeping the muscles strong and flexible.

Taking charge from the very onset of this condition will help the individual to attain the relief from pain and disability that will return them to a happier, pain-free existence. The homecare can be the most defining factor in obtaining a speedy recovery, or for not, allowing this condition to progress to a point where there will be ongoing pain and muscle atrophy. Should it reach that stage, normal life will not be the same. Everyday activities, such as household chores, work, and sports will not be part of the normal daily activities, and enjoying life will not be possible to the fullest extent that it can be.

No comments:

Post a Comment