Thoracic Outlet Syndrome Treatment Options
Surgery can be performed for TOS and pectoralis minor syndrome, but it should be regarded as a last resort. Non-surgical forms of treatment should always be tried first.
Treatment begins with physical therapy and neck stretching exercises. Abdominal breathing, posture correction, and nerve glides performed daily, are a part of the therapy program. Gentle, slow movements and exercises are stressed. Methods like Feldenkrais have helped many people with TOS. Modalities to avoid are those that emphasize strengthening exercises, such as therabands, heavy weights, and painful stretching. It is important to be examined and tested for other causes of these symptoms because other conditions can coexist with TOS, and these should be identified and treated separately. Some of these associated conditions include carpal tunnel syndrome, ulnar nerve entrapment at the elbow, shoulder tendinitis and impingement syndrome,
Thoracic Outlet Surgery
Surgery is designed to take pressure off the nerves to the arm by removing the muscles that surround the nerves (scalene muscles), by removing the first rib, or by doing both (removing muscles and first rib). All three procedures (transaxillary first rib resection, scalenectomy, and combined rib resection and scalenectomy) have limitations; there is no perfect operation.
Recurrent symptoms of pain, numbness and tingling is most often the result of scar tissue formation during the healing period. This occurs regardless of which operation is performed.
Center for Thoracic Surgery patients share their experiences in our Patient Success Stories.