Do you ever experience numbness, tingling, and/or aching pain in your arm or shoulder? Does this worsen with overhead reaching? Do you have pain in your upper back or neck? These can all be the signs of a condition called thoracic outlet syndrome. This article will discuss some of the causes and treatment options for this condition.
What is the Thoracic Outlet?
The thoracic spine is characterized by its articulation with our ribs. At the top of this portion of the spine – levels T1 and T2 – the first two sets of ribs are found on either side of the vertebrae. They sit just below the collarbone which spans from the shoulder to the sternum. The space between the collarbone and the first two ribs is known as the thoracic outlet. It is called this because there are arteries, veins, and nerves that travel through this space. If there is a musculoskeletal abnormality that causes compression of these structures, symptoms of numbness, tingling, aching, or weakness can be present in the upper extremity.
What Causes This?
Compression of the structures that pass through the thoracic outlet can occur due to several different factors. Some are born with what is called a cervical rib; or an extra rib that stems from the cervical spine. This accounts for a very small percentage of thoracic outlet syndrome cases. Typically, compression of the structures traveling through the thoracic outlet will be due to one or more of the following factors: whiplash injury, repetitive overhead motions, weightlifting, poor posture, or tumor formation. Additionally, limited mobility in the cervical or thoracic spine can contribute to these symptoms.
How Can I Treat This?
The first step in addressing thoracic outlet syndrome is identifying a potential cause. Seeing a physical therapist is a great way to identify any deficits that could be contributing to the onset of symptoms. Certain stretches and/or strengthening exercises are often prescribed to improve posture and reduce any limitations stemming from soft-tissue structures. Manual therapeutic techniques such as joint mobilization in the cervical or thoracic spine may also be employed to improve mobility and reduce the compression of the nerves that travel through this area and down into the arm. Exercises targeting mobility of the shoulder and spine can also help to provide some relief. When combined, these treatment approaches can result in long term symptom relief.
If you or someone you know is suffering from persistent shoulder, neck, or back pain, physical therapy can provide relief. Call Respire Physical Therapy today at 703-671-1871 or click here to schedule an evaluation with a Physical Therapist today to reduce your symptoms and get back to your favorite activities!
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