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Thoracic Outlet Syndrome

Symptoms: pain over neck and shoulders. For severe cases, upper limbs numbness, muscles atrophy or weak pulse would be encountered.

Consequence: head and neck movements would aggravate the upper limbs numbness, causing upper limb muscles atrophy.

Causes: cervical spine displacement, clavicle and first rib displacement, upper and lower scalene muscles disorders, thickened ligaments, etc. would cause compression on nerves around the clavicle and cervical

Thoracic outlet syndrome introduction: 40% caused by trauma; 1% caused by congenital cervical-costal disorders. These two conditions would cause compression on the nerves and blood vessels over the first rib. Chiropractic assessments, x-ray and MRI would be used to achieve the diagnosis before prescribing the most effective treatments. Patients with severe upper limb numbness and swollen arms may need surgical interventions.

Nutrition: vitamins B1, B6, B12 with magnesium and calcium supplements.

Medications: NSAIDs (with side effect of causing abdominal disorders, not suitable for long term use)

Chiropractic adjustment: by means of lever concept in biomechanics, help restore the balance within the cervical spines and improve the spinal posture. Together with first rib manipulation, the nerve compression can be released.

Exercise therapy: muscle strengthening exercise, e.g. lower scalene muscle; muscle relaxation / stretching exercise, e.g. pectoral major muscle release.

Physiotherapy: short wave diathermy, heat treatment, 2D lumbar traction, interferential therapy, etc. would be used for muscles relaxation and symptomatic relief.


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