How to Diagnosis TOS?
Diagnosing thoracic outlet syndrome can be difficult because the symptoms and their severity can vary greatly among people with the disorder.
To diagnose thoracic outlet syndrome, your doctor may review your symptoms and medical history and conduct a physical examination.
Provocation tests are designed to try to reproduce your symptoms.
The tests may help your doctor determine the cause of your condition and help rule out other causes that may have similar symptoms.
In these tests, your doctor may ask you to move your arms, neck or shoulders in various positions.
Your doctor will check your symptoms and examine you in different positions.
In most cases, a conservative approach to treatment is effective, especially if your condition is diagnosed early. Treatment may include:
Massage & Physical therapy. If you have neurogenic thoracic outlet syndrome, physical therapy is the first line of treatment. You’ll learn how to do exercises that strengthen and stretch your shoulder muscles to open the thoracic outlet, improve your range of motion and improve your posture.
These exercises, done over time in tandem with regular massage, may take the pressure off your blood vessels and nerves in the thoracic outlet.
Clot-dissolving medications. If you have venous or arterial thoracic outlet syndrome and have blood clots, your doctor may administer clot-dissolving medications (thrombolytics) into your veins or arteries to dissolve blood clots.
After you’re given thrombolytics, your doctor may prescribe medications to prevent blood clots (anticoagulants).
Your doctor may recommend surgery if other treatment hasn’t been effective, if you’re experiencing ongoing symptoms or if you have progressive neurological problems.
Thoracic outlet syndrome surgery has risks of complications, such as injury to the brachial plexus. Also, surgery may not relieve your symptoms, and symptoms may recur.
In venous or arterial thoracic outlet syndrome, your surgeon may deliver medications to dissolve blood clots prior to thoracic outlet compression.
If you have arterial thoracic outlet syndrome, your surgeon may need to replace the damaged artery with a section of an artery from another part of your body (graft) or an artificial graft.
This procedure may be done at the same time as your procedure to have the first rib removed.
If you’re diagnosed with thoracic outlet syndrome, your doctor or physical therapist will instruct you to do exercises at home to strengthen and support the muscles surrounding your thoracic outlet.
In general, to avoid unnecessary stress on your shoulders and muscles surrounding the thoracic outlet:
· Maintain good posture
· Take frequent breaks at work to move and stretch
· Maintain a healthy weight
· Avoid carrying heavy bags over your shoulder
· Avoid activities that worsen symptoms, or find ways to adapt activities so that they don’t cause symptoms
· Create a work area that allows you to keep good posture and doesn’t make symptoms worse
What you can do in the meantime?
While you’re waiting for your appointment, try taking a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Advil, Motrin IB, others).
Your discomfort also may be improved if you maintain good posture and avoid using repetitive movements and lifting heavy objects.
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