Are you experiencing numbness or tingling of the fingers? Are your arms falling asleep at night? Is your neck and arms in constant pain?
There is a good chance that you are suffering from thoracic outlet syndrome. There are 3 main areas of impingement, usually from tight muscles. The scalene muscle group in the neck and the pectoralis minor between the chest and arm are the main culprits.
Thoracic outlet syndrome (TOS) is the general term used to describe a condition caused by the compressing of the nerves and blood vessels between the neck and shoulders.
The symptoms of thoracic outlet syndrome include pain, arm and hand weakness, and numbness in the arm and fingers. In some cases, the sense of touch, or the ability to feel heat and cold may be lost.
Thoracic outlet syndrome is a complex disorder characterized by a mixture of signs and symptoms resulting from the compression of blood vessels and nerves (neurovascular bundle) in the thoracic outlet region where they exit the chest. The thoracic outlet is a space located between the thorax (rib cage) and the clavicle (collar bone) which contains major blood vessels (subclavian artery and vein) and nerves (brachial plexus). The thoracic outlet is the area through which nerves and blood vessels travel to and from the arm.
Thoracic outlet syndrome is considered a "syndrome" since it involves multiple systems, including:
Neural (nerve) complexes, Vascular structures and the Musculoskeletal system
Proper bone alignment is very important to prevent thoracic outlet syndrome.Tthe neck vertebrae, first rib and collarbone must be aligned properly to allow enough space for the brachial plexus and the subclavian blood vessels to pass through the correct path without obstruction or interference.
Proper muscle alignment is very important. The muscles of the upper body must be aligned in the correct form, particularly the scalene muscles. The scalene muscles consist of three powerful muscles on each side of the neck that bend and rotate the neck, and assist in breathing by raising the first two ribs during inspiration (breathing in). The ideal posture which promotes the most appropriate muscle alignment is when the head sits directly atop the shoulders which we identify as erect posture.
There are actually three spaces where compression can occur causing the symptoms of thoracic outlet syndrome , including:
The thoracic outlet (scalene triangle) is located at the base of the neck above the first rib and behind the clavicle. This space lies closest to the neck and the boundaries of the thoracic outlet consist of:
- 1 The Anterior Scalene muscle which forms the front of the thoracic outlet
- 2 The Middle Scalene muscle which forms the back of the thoracic outlet
- 3 The First Rib which forms the bottom of the thoracic outlet.
The prevention of thoracic outlet syndrome should focus on the design of the workplace so that workers will avoid carrying heavy weights, reaching overhead, and lifting with the arms above shoulder level. Routine conditioning to strengthen muscles and improve posture can reduce pressure on nerves and blood vessels. Stretching, yoga, pilates and massage are excellent therapy to help relieve the symptoms.
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