Materiały źródłowe

• #1 Thoracic outlet syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/diagnosis-treatment/drc-20353994

  Diagnosing thoracic outlet syndrome can be challenging. Symptoms can vary greatly among people. Your healthcare professional may review your symptoms and medical history and conduct a physical exam. You also may need imaging and other types of tests. […] Physical therapy is the first line of treatment. The exercises strengthen and stretch your shoulder muscles to open the thoracic outlet. This improves your range of motion and posture. These exercises, done over time, may take the pressure off the blood vessels and nerves in the thoracic outlet. […] If you have neurogenic thoracic outlet syndrome, physical therapy is the first line of treatment. The exercises strengthen and stretch your shoulder muscles to open the thoracic outlet. This improves your range of motion and posture. […] A conservative approach to treatment may be effective for most people, especially if your condition is diagnosed early. Treatment may include:

• #1 Thoracic Outlet Syndrome | Society for Vascular Surgery

  https://vascular.org/your-vascular-health/vascular-conditions/thoracic-outlet-syndrome

  Thoracic outlet syndrome (TOS) is an uncommon medical condition that happens when the nerves and blood vessels between the neck and shoulder are pinched and compressed between the collarbone and top rib. This area is called the thoracic outlet. TOS can cause arm and hand pain, numbness, weakness, and swelling. […] Best results come from a combination of medical treatment and physical therapy. Specifics will vary depending on the source of the condition. […] Specialized physical therapy and injections to relieve muscle spasm may resolve your symptoms. […] If symptoms are severe and persist and you are a good candidate for surgery, a procedure called thoracic outlet decompression is the next step. […] If surgery is not suitable for you or does not relieve your symptoms, you will want to consider ongoing medication to manage pain. […] If arterial compression is diagnosed, a surgery called thoracic outlet decompression is the next step. […] If arm swelling or a blood clot in the vein is due to thoracic outlet compression, thoracic outlet decompression is the next step.

• #1 Thoracic Outlet Syndrome | Mount Sinai – New York

  https://www.mountsinai.org/care/surgery/services/vascular-surgery/conditions/other-conditions/thoracic-outlet

  Thoracic outlet syndrome develops when your blood vessels or nerves become compressed between your collarbone and first rib or neck. This may cause pain or make blood flow difficult. You might even find that your arm and hand become swollen and discolored or pale. You might also feel achy, tingly, or numb in your arm and hand and you might have difficulty finding a pulse in certain positions. At Mount Sinai, we have the expertise and sophisticated equipment to diagnose and treat this condition. […] We usually take a conservative approach to treatment, especially if we diagnose your condition early. We often use: […] Physical therapy can strengthen and stretch your muscles to improve your range of motion and posture, which can then remove some of the pressure from your blood vessels. […] Medication, such as anti-inflammatory, pain, or muscle relaxants, can help with your symptoms. We can also use clot-dissolving medication to dissolve blood clots and prevent new clots from forming.

• #1 Thoracic Outlet Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557450/

  The interprofessional approach will yield the best patient outcomes in TOS. […] Nursing staff can demonstrate the proper use of braces and splints and answer questions for the patient. They can also monitor progress and inform the clinician of any status changes. […] In surgical cases, nurses and surgical assistants can be invaluable for assisting the surgeon as well as monitoring and providing postoperative care, with PT and rehabilitation to follow.

• #1 Thoracic Outlet Syndrome | Nurse Key

  https://nursekey.com/thoracic-outlet-syndrome/

  1. Identify nursing implications relevant to patients with thoracic outlet syndrome. […] […] 2. In the absence of a specific gold standard test for TOS, an accurate clinical history and evaluation are paramount in assessing patients. […] […] 3. Nursing interventions include assessing pain level on a specific scale, identifying aggravating and alleviating factors, and setting pain level targets with patients. […] […] 4. Reinforce physical therapy exercise programs. […] […] 5. Encourage participation by family members/significant others in the process. […] […] 6. Evaluate sleep patterns and provide measures to induce sleep, such as soft music and proper positioning at night. […] […] 7. Assess current knowledge level regarding disease processes, treatment options, and pain control. […]

• #1 Thoracic Outlet Syndrome | Nurse Key

  https://nursekey.com/thoracic-outlet-syndrome/

  8. Monitor lung sounds and respiratory rate at regular intervals to prevent potential complications such as atelectasis and pneumonia. […] […] 9. Assess arterial and venous circulation to maintain adequate circulation and perfusion to the affected extremity. […] […] 10. Monitor vital signs at regular intervals to prevent infection.

• #1 Thoracic Outlet Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557450/

  Thoracic outlet syndrome (TOS) presents in a vague and nondescript way. […] This activity summarizes the diagnosis and management of patients with thoracic outlet syndrome and highlights the role of the interprofessional team in the care of patients with this condition. […] Describe the interprofessional team strategies for improving care coordination and communication to enhance the care of thoracic outlet syndrome and improve outcomes. […] Physical therapy is a mainstay as first-line treatment for patients suffering from TOS. For many patients, the cause of the condition is muscular imbalance. Physical therapy aims to strengthen the muscles around the thoracic outlet to relieve pressure on the impaired structures. […] Once these complications receive treatment and resolve, the patient must undergo rehabilitation. Much like physical therapy, it aims at strengthening the muscles of the thoracic outlet, but it also encompasses regaining normal function if such function was lost.

• #1 Thoracic outlet syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/diagnosis-treatment/drc-20353994

  Your healthcare professional may recommend surgery if conservative treatments haven’t been effective. Or you might consider surgery if you experience ongoing or worsening symptoms. […] Thoracic outlet syndrome surgery has risks of complications, such as injury to the nerves, known as the brachial plexus. Also, surgery may not relieve your symptoms or only partially relieve your symptoms, and symptoms may come back. […] If you’re diagnosed with thoracic outlet syndrome, a physical therapist may instruct you to do exercises at home. The exercises can 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. Create a work area that allows you to keep good posture and doesn’t make symptoms worse. Gently massage your shoulders and thoracic outlet. Apply a heating pad to the area. Practice relaxation exercises such as deep breathing, meditation and stretching.

• #1

  https://link.springer.com/article/10.1007/s40122-019-0124-2

  Prompt recognition of the presenting signs of TOS is crucial to prevent long-term sequelae, specifically chronic upper extremity pain and severe disability. […] In each subtype of TOS, an understanding of the causative anatomic aberrancy can guide diagnosis. […] Diagnosis of TOS is further complicated by alternative disorders with similar presentation. […] Clinicians should recall TOS on their differential diagnosis when confronted with a patient suffering from upper extremity pain and supporting physical exam findings. […] Management strategies depend on the underlying etiology of TOS. Initial treatment of nTOS consists of conservative measures, whereas vTOS or nTOS with refractory symptoms may undergo surgical management. […] Surgery for TOS is reserved for patients who have failed conservative management.

• #1 Thoracic Outlet Syndrome: Understanding Symptoms, Causes, and Management

  https://longmoreclinic.org/thoracic-outlet-syndrome-understanding-symptoms-causes-and-management/

  Chronic pain conditions like Thoracic Outlet Syndrome can take a toll on mental well-being. […] Athletes who engage in sports requiring repetitive arm movements, such as swimming, baseball, and weightlifting, may be at an increased risk of developing TOS. […] While less common, children and adolescents can also develop Thoracic Outlet Syndrome. […] The prognosis for individuals with Thoracic Outlet Syndrome varies depending on the severity of the condition, the effectiveness of treatments, and how well individuals adhere to self-care recommendations. […] Ongoing research in the field of thoracic outlet syndrome aims to improve our understanding of its causes, diagnostic methods, and treatment options.

• #1 Thoracic Outlet Syndrome (TOS): Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17553-thoracic-outlet-syndrome-tos

  Thoracic outlet syndrome (TOS) occurs when theres compression of nerves or blood vessels in your lower neck and upper chest. Symptoms include pain, tingling and numbness in your arms and hands. Common causes include vigorous arm movements (especially in sports), traumatic injuries and anatomical variations youre born with. […] Conservative treatments like physical therapy and pain medications help most people. But you may need surgery if those methods dont work or if TOS interferes with normal blood flow. […] Physical therapy: This is the most common initial treatment for neurogenic TOS. A physical therapist helps you increase your range of motion (how far you can move) in your neck and shoulders. Physical therapy also strengthens your muscles and promotes better posture. Most people with neurogenic TOS see an improvement in symptoms.

• #1 Thoracic Outlet Syndrome Treatment & Management: Acute Phase, Recovery Phase, Maintenance Phase

  https://emedicine.medscape.com/article/96412-treatment

  Physiotherapy focuses on pain control and range of motion with specific stretching exercises. […] Postoperative physical therapy is essential for strengthening and range of motion. […] Continued regular stretching of the muscles around the cervical girdle (eg, scalene, pectoralis major and minor, trapezius, levator scapulae, and sternocleidomastoid muscles) is essential. […] Recommended exercises for thoracic outlet syndrome include neck stretching, abdominal breathing, and postural exercises. […] To help prevent recurrence of thoracic outlet syndrome, the patient should avoid sleeping with his or her arms in an overhead position. […] The patient should avoid repetitive motions, stressful lifting, and overhead work. Performing a regular exercise program for improving flexibility and strength is beneficial.

• #1 Thoracic Outlet Syndrome Signs & Symptoms | Rush

  https://www.rush.edu/conditions/thoracic-outlet-syndrome

  If you have neurogenic TOS, you may be able to get relief from your symptoms through physical therapy. Typically, physical therapy is the first part of your treatment plan. […] RUSH offers a three-month physical therapy treatment to help you manage your TOS symptoms. This treatment focuses on the following: Improving movement of your neck and shoulder, Strengthening your neck and shoulder muscles, Practicing better posture and body alignment so your muscles can work together most effectively, Breathing techniques, like diaphragmatic breathing, to help provide relief to muscles associated with breathing. […] At the end of your physical therapy, you will follow up with your doctor. If your symptoms have not lessened, your doctor may recommend additional treatments. […] If you have venous or arterial TOS, your symptoms may be more advanced. In this case, your doctor will likely recommend surgery as the most effective treatment.

• #1 Thoracic Outlet Syndrome | Vascular Center | UC Davis Health

  https://health.ucdavis.edu/vascular/diseases/TOS.html

  Thoracic outlet syndrome (TOS) occurs when the vessels and/or nerves running from the upper body to the arm become compressed, leading to swelling, reduced blood flow, tingling, weakness, pain and/or numbness in the neck, shoulder, arms or hands. […] Treatment plans are tailored based on the type of TOS and length of symptoms and can encompass conservative therapies and surgery. Nonsurgical approaches include: […] Follow-up care is dependent on the type of TOS. Venous TOS patients undergo a venogram an X-ray using contrast dye to make sure vessels are not narrowed two weeks after surgery with ultrasound exams for up to one year. These patients also require a short course of blood thinners. Patients with arterial TOS require ultrasound evaluations following surgery at regular intervals. All TOS patients require at least two months (sometimes up to a year) of physical therapy to build up the shoulder muscles.

• #1 Thoracic Outlet Syndrome (TOS) | University of Iowa Health Care

  https://uihc.org/services/thoracic-outlet-syndrome-tos

  Your provider may ask you to lose weight, avoid repetitive arm motions, or change the layout of your workspace to promote better posture. […] Anti-inflammatory medicines like ibuprofen or naproxen sodium can reduce pain and inflammation if you have mild TOS. […] Our physical therapists can teach you exercises to strengthen your shoulder and neck muscles, which helps stabilize your collarbone. […] If your symptoms are too advanced and nonsurgical treatments don’t help or if you have venous or arterial TOS, which have a higher risk of complications, your provider may recommend surgery. […] Because the thoracic outlet affects so many important nerves, blood vessels, and other tissues in the neck and chest, it’s important to seek care from specialists who have experience performing TOS surgery. […] UI Heart and Vascular Center surgeons are trained in these sophisticated techniques. They also help teach them to other surgeons.

• #1

  https://umiamihealth.org/en/treatments-and-services/vascular-disease/thoracic-outlet-syndrome

  Certain medications such as anti-inflammatory medicine, pain medicine, or muscle relaxants can be used to decrease inflammation, reduce pain, and relax muscles. […] If you have vascular thoracic outlet syndrome that has caused blood clots, your doctor may administer clot-busting medications (thrombolytics) directly into your veins or arteries to help break up the clots. After this, you may take a regular regimen of clot-preventing medication (anticoagulants). […] If other treatments haven’t been effective for neurogenic thoracic outlet syndrome or if you have evidence of vascular thoracic outlet syndrome, your doctor may recommend you undergo surgery to relieve symptoms and complications related to thoracic outlet syndrome. There are several types of thoracic outlet decompression, but they all involve decreasing pressure on the affected nerves or blood vessels. It typically requires removal of the first thoracic rib and the anterior scalene muscle. […] Our group of vascular and thoracic surgeons are experts on all surgical approaches for thoracic outlet decompression, including robotic-assisted surgery.

• #1 Thoracic Outlet Syndrome (TOS)

  https://www.cincinnatichildrens.org/health/t/thoracic-outlet-syndrome

  After surgery, there is a therapy protocol to help patients in their return to activity. More than 85% of surgical patients return to prior activity level without symptoms. […] A referral to the Pain Clinic may be recommended to reduce pain symptoms. The goal is to make the pain manageable for daily activities and physical therapy. Cognitive behavioral therapy may be used as well to target nerve pain or muscle tightness.

• #1 Thoracic Outlet Syndrome for International Patients | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/international/treatments-and-specialties/thoracic-outlet-syndrome

  Our Thoracic Outlet Syndrome Program and Division of Thoracic Surgery provide world-leading diagnosis, treatment and care to patients with all forms of thoracic outlet syndrome (TOS), including neurogenic, venous and arterial TOS. […] Many patients can be treated for TOS without surgery. Common treatments include ultrasound-guided injections in the neck and upper chest region, medications, and physical therapy. Often, a combination of these treatments provides optimal results. […] Your doctor may recommend surgery to treat your TOS. This may include decompression surgery, vein repair, or rarely artery repair. […] The goal of surgery is to take pressure off the nerves and allow the body to use its own healing process in helping the nerve to recover. The vast majority of patients improve significantly after surgery. […] The Mass General Brigham TOS team will ensure you understand your healthcare choices and have the necessary information to make decisions affecting your health and well-being as an international patient.

• #1 Thoracic Outlet Syndrome | Mount Sinai – New York

  https://www.mountsinai.org/care/surgery/services/vascular-surgery/conditions/other-conditions/thoracic-outlet

  We can also use thoracic outlet decompression if necessary. We have three approaches to this technique: […] Transaxillary approach involves making an incision in your chest and removing a portion of your first rib, to decrease the pressure on your blood vessels. […] Supraclavicular approach involves repairing the narrowed blood vessels by removing muscles and repairing blood vessels. We may also remove your first rib. […] Infraclavicular approach can help us repair narrowed veins. […] Sometimes we combine these techniques with reconstructive procedures of the arteries or veins.

• #1 Thoracic Outlet Syndrome | The University of Kansas Health System

  https://www.kansashealthsystem.com/care/conditions/thoracic-outlet-syndrome

  Thoracic outlet syndrome (TOS) is an uncommon condition that can occur when the nerves and blood vessels coming from the spine or a major vessel of your body pass through a narrow area between the shoulder and armpit continuing down the arm. The narrowness of this channel can put pressure on the nerves and blood vessels, causing pain and weakness. […] Specialists at The University of Kansas Health System in Kansas City are highly experienced in treating thoracic outlet syndrome and other types of vascular disease. Our team combines experience with leading-edge technology as well as access to academic research and clinical trials for the most advanced treatment options. […] Once your physician has diagnosed thoracic outlet syndrome, physical therapy and/or surgery may be recommended. The types of surgery that are performed to correct TOS are: […] Removal of a section of the first rib to relieve pressure […] Removal of the extra rib and some muscles.

• #1 Thoracic Outlet Syndrome | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/thoracic-outlet-syndrome

  Following surgery, patients have a short inpatient hospital stay and then are discharged home, active and able to perform daily activities. During the next few months, a comprehensive physical and occupational therapy program allows patients to resume unrestricted activity. Patients follow a pre-set medication taper regimen so they are off all post-operative medications by six months. […] Following surgery, patients have a short inpatient hospital stay and then are discharged home, active and able to perform daily activities. During the next few months, a comprehensive physical and occupational therapy program to allow patients to resume unrestricted activity. Patients follow a pre-set medication taper regimen so that patients are off all post-operative medications by six months. […] Following surgery, patients have an inpatient hospital stay and then are discharged home, active and able to perform daily activities. During the next few months, a comprehensive physical and occupational therapy program allows patients to resume unrestricted activity. Patients follow a pre-set medication taper regimen such that patients are off all post-operative medications by six months.

• #1 Patient Education | Concord Orthopaedics

  https://www.concordortho.com/patient-resources/patient-education/topic/44a14668f9e0b1eafc5748bb059b5c60

  After Surgery […] Your rehabilitation will likely be more complex after surgery. Patients wear a sling after surgery to support the shoulder and arm. Passive movements can begin soon after surgery. But there should be no active motion for about two weeks, to allow the soft tissues time to heal. Patients usually start doing resistive exercise and activities after three to four weeks. Therapy treatments help improve motion in the shoulder blade and arm. Posture and strengthening exercises help prevent future TOS problems.

• #1 Exercises for Thoracic Outlet Syndrome

  https://www.healthline.com/health/thoracic-outlet-syndrome-exercises

  Stretching can play a helpful role in your recovery of neurogenic thoracic outlet syndrome. […] While no exercises are officially off-limits, you may need to limit certain movements during recovery from neurogenic thoracic outlet syndrome. […] Its often recommended you limit or avoid overhead movements or exercises that require lifting heavy loads (e.g., dumbbells, barbells, etc.) until you’ve received clearance from your physical therapist or healthcare team. […] Recovering from thoracic outlet syndrome requires focusing on strengthening the back muscles more than the front. […] Treatment for thoracic outlet syndrome depends on the type and severity of the condition, which is why it is crucial to get a proper diagnosis from a qualified healthcare professional. […] Once you have received your diagnosis, your healthcare team may recommend physical therapy as a first step of treatment, especially in those with neurogenic thoracic outlet syndrome.

• #1 Thoracic Outlet Syndrome

  http://healthlibrary.methodisthealthsystem.org/134,590?&

  Contact your provider right away if your arm or hand becomes suddenly cool, lighter in color, or swollen. You may have a blood clot. Let your provider know right away about any other sudden changes in your symptoms, like sudden weakness of your hand, difficulty breathing, or chest pain. If your symptoms are not getting better with therapy, plan to see your provider soon.

• #1 Thoracic outlet syndrome – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988

  Thoracic outlet syndrome is often caused by compression of the nerves or blood vessels in the thoracic outlet, the area between the neck and shoulder. The cause of the compression varies and can include: […] Treatment often involves physical therapy and pain relief. Most people improve with these treatments. For some, surgery may be recommended. […] If you’re at risk of thoracic outlet compression, avoid repetitive movements and lifting heavy objects. If you’re overweight, losing weight may help you prevent or relieve symptoms of thoracic outlet syndrome. […] Daily stretches focusing on the chest, neck and shoulders can help improve shoulder muscle strength and prevent thoracic outlet syndrome. […] See your healthcare professional if you regularly experience any of the symptoms of thoracic outlet syndrome.

• #1 Thoracic Outlet Syndrome | Heart and Vascular

  https://health.ucdavis.edu/conditions/thoracic-outlet-syndrome

  Thoracic outlet syndrome can cause swelling, pain and discomfort. Our specialists offer a range of treatments to help you find relief. […] At UC Davis Health, we provide expert care for all types and combinations of thoracic outlet syndrome. Specialists across our health system work together seamlessly to meet your unique needs. […] Treating thoracic outlet syndrome requires a specialized team approach. Your care team may include: heart and blood vessel (vascular) specialist, musculoskeletal (orthopaedic) specialist, physical therapist, chest (thoracic) surgeon, blood vessel surgeon. With a skilled team guiding your care, treatment is usually very effective. […] Physical therapy can help relieve nerve and blood vessel compression by strengthening your chest and neck muscles and improving your posture.

• #1 Thoracic outlet syndrome (TOS) – Vascular surgery | Northwell Health

  https://www.northwell.edu/vascular-surgery/conditions/thoracic-outlet-syndrome

  With the right care, we can help you manage your condition allowing you to enjoy an active and fulfilling life. […] Treatment for TOS depends on the type and severity of the condition and includes: […] Nonsurgical approaches: […] Physical therapy: Stretching and strengthening exercises to reduce compression […] Medications: Anti-inflammatories or blood thinners to manage pain or clotting […] Injections: Botox or steroids to relax muscles and alleviate compression […] Surgical options: […] Rib resection: Removal of the first rib or cervical rib to decompress the area […] At Northwell, we understand this challenge. Our multidisciplinary team of vascular surgeons, thoracic surgeons, orthopedic surgeons, neurologists, physiatrists and physical therapists collaborates to provide accurate diagnoses and personalized, evidence-based treatment plans getting you back to the activities you love.

• #1 Thoracic Outlet Syndrome (TOS) | University of Iowa Health Care

  https://uihc.org/services/thoracic-outlet-syndrome-tos

  Thoracic outlet syndrome (TOS) is a condition that causes pain, weakness, numbness, or other symptoms in your arm, hand, or fingers. It occurs when the nerves and blood vessels that run through the thoracic outlet are pinched or blocked. […] When left untreated, TOS can cause serious complications. And because TOS is relatively rare but has symptoms that are similar to symptoms of other conditions, a skilled TOS specialist is often needed to diagnose it. […] If you have any TOS symptoms, you should ask for a referral to a vascular surgeon. Without proper diagnosis and treatment, TOS can cause blood clots, gangrene, or permanent arm pain or weakness. […] Treatments for TOS vary, depending on the type of TOS you have and the severity of your symptoms. […] For many people with neurogenic TOS, symptoms can be managed with nonsurgical treatments.

• #1 Thoracic Outlet Syndrome Signs & Symptoms | Rush

  https://www.rush.edu/conditions/thoracic-outlet-syndrome

  RUSH vascular surgeons can help relieve your neck, arm or shoulder pain caused by thoracic outlet syndrome (TOS) through targeted physical therapy or surgery. […] Vascular surgeons at RUSH provide expert care for all types of TOS. They can diagnose and relieve symptoms unique to your TOS condition. […] Our goal with treatment is to ease your pain and symptoms. Without treatment, your TOS may cause these other health problems: Permanent arm swelling, pain or weakness, Permanent nerve damage, Gangrene (when blood stops flowing to a specific area of your body, resulting in dead body tissue), Blood clots. […] Your first step in getting proper treatment is to discuss options with your RUSH provider. They may recommend a nonsurgical treatment, surgery or a combination to best manage your TOS symptoms.

• #1

  https://www.orthobullets.com/shoulder-and-elbow/3064/thoracic-outlet-syndrome

  Thoracic outlet syndrome is a neurovascular disorder resulting from compression of the brachial plexus and/or subclavian vessels in the interval between the neck and axilla. […] Treatment may be nonoperative or include surgical decompression or a vascular procedure depending on the specific etiology. […] Nonoperative activity modification, pain control, physical therapy and modalities are the first line of treatment. […] Pain control includes NSAIDs and muscle relaxants. […] Physical therapy focuses on core and back strengthening, shoulder girdle strengthening, improving posture and relaxation techniques. […] Surgical treatment may involve thoracic outlet decompression, which includes first rib resection, anterior and middle scalenectomy, and neurolysis. […] Complications of surgery include pneumothorax, which is one of the most common complications of first rib resection.

• #1 Thoracic Outlet Syndrome (TOS) Causes, Symptoms, Treatments

  https://www.upmc.com/services/heart-vascular/conditions/thoracic-outlet-syndrome

  Thoracic outlet syndrome (TOS) is a disorder that may compress the blood vessels or nerves in the upper chest region. This area called the thoracic outlet is behind and below the collarbone opposite the first rib. […] At UPMC, we take a team approach to quickly and correctly diagnosing TOS. Then, we’ll create a treatment plan that’s right for you. […] TOS can occur on either side of the body but most often affects your dominant hand’s side because of constant use. […] Early diagnosis and treatment of TOS are key to reducing the risk of complications and delivering a successful treatment outcome. Your prognosis will depend on the type of TOS you have, as well as the severity of your condition. […] Vascular surgeons at UPMC offer a range of treatments for arterial, venous, and neurogenic TOS.

• #1 Thoracic Outlet Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30073

  Overall, the prognosis is excellent in patients with thoracic outlet syndrome. […] Patients who undergo conservative therapy have their symptoms resolve in about 90% of cases. […] Thoracic outlet syndrome (TOS) is a family of conditions in which either the blood vessels or nerves are compressed, resulting in nonspecific symptoms such as numbness, tingling, and weakness in the affected area. […] Non-surgical treatment modalities, such as physical therapy, are the first line of treatment, and patients generally respond well. […] Once TOS is controlled, and the patient is symptom-free, the patient may need to participate in maintenance physical therapy to prevent any relapse of the condition. […] In addition to preventive treatment, patients should not perform any repetitive tasks and avoid overhead lifting as much as possible. […] The interprofessional approach will yield the best patient outcomes in TOS.

• #1

  https://link.springer.com/article/10.1007/s40122-019-0124-2

  Overall outcomes from surgical decompression are very positive. Following surgical intervention, 95% of patients with nTOS reported excellent results. […] A systematic, organized approach to the diagnosis and treatment of TOS provides an opportunity for specialists to deliver patient-centered care and achieve optimal results.

• #2 Thoracic Outlet Syndrome (TOS): Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17553-thoracic-outlet-syndrome-tos

  Thoracic outlet syndrome (TOS) occurs when theres compression of nerves or blood vessels in your lower neck and upper chest. Symptoms include pain, tingling and numbness in your arms and hands. Common causes include vigorous arm movements (especially in sports), traumatic injuries and anatomical variations youre born with. […] Conservative treatments like physical therapy and pain medications help most people. But you may need surgery if those methods dont work or if TOS interferes with normal blood flow. […] Physical therapy: This is the most common initial treatment for neurogenic TOS. A physical therapist helps you increase your range of motion (how far you can move) in your neck and shoulders. Physical therapy also strengthens your muscles and promotes better posture. Most people with neurogenic TOS see an improvement in symptoms.

• #2 Thoracic Outlet Syndrome (TOS)

  https://www.cincinnatichildrens.org/health/t/thoracic-outlet-syndrome

  The thoracic outlet is a space in the neck / upper chest where the major blood vessels (subclavian artery and vein) exit the chest and meet up with the major nerves to the arm (brachial plexus). […] Symptoms of TOS can include pain in the shoulders and neck, numbness and tingling in the affected arm(s). Immediate care should be sought for temperature changes, swelling in the affected arm lasting longer than 60 minutes, sudden weakness and / or paleness and coldness of the hand. […] Non-surgical treatment for those with neurogenic TOS may include activity modification and physical therapy. There is a low success rate for long-term resolution of symptoms without significantly changing activity levels. This may look like stopping a sport or changing a job that included the repetitive overhead motions resulting in TOS. Surgery may be needed when activity modification or physical therapy doesn’t work or is not appropriate for the condition.

• #2 Thoracic Outlet Syndrome | Nurse Key

  https://nursekey.com/thoracic-outlet-syndrome/

  1. Identify nursing implications relevant to patients with thoracic outlet syndrome. […] […] 2. In the absence of a specific gold standard test for TOS, an accurate clinical history and evaluation are paramount in assessing patients. […] […] 3. Nursing interventions include assessing pain level on a specific scale, identifying aggravating and alleviating factors, and setting pain level targets with patients. […] […] 4. Reinforce physical therapy exercise programs. […] […] 5. Encourage participation by family members/significant others in the process. […] […] 6. Evaluate sleep patterns and provide measures to induce sleep, such as soft music and proper positioning at night. […] […] 7. Assess current knowledge level regarding disease processes, treatment options, and pain control. […]

• #2 Thoracic Outlet Syndrome | Nurse Key

  https://nursekey.com/thoracic-outlet-syndrome/

  8. Monitor lung sounds and respiratory rate at regular intervals to prevent potential complications such as atelectasis and pneumonia. […] […] 9. Assess arterial and venous circulation to maintain adequate circulation and perfusion to the affected extremity. […] […] 10. Monitor vital signs at regular intervals to prevent infection.

• #2 Thoracic outlet syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/diagnosis-treatment/drc-20353994

  Diagnosing thoracic outlet syndrome can be challenging. Symptoms can vary greatly among people. Your healthcare professional may review your symptoms and medical history and conduct a physical exam. You also may need imaging and other types of tests. […] Physical therapy is the first line of treatment. The exercises strengthen and stretch your shoulder muscles to open the thoracic outlet. This improves your range of motion and posture. These exercises, done over time, may take the pressure off the blood vessels and nerves in the thoracic outlet. […] If you have neurogenic thoracic outlet syndrome, physical therapy is the first line of treatment. The exercises strengthen and stretch your shoulder muscles to open the thoracic outlet. This improves your range of motion and posture. […] A conservative approach to treatment may be effective for most people, especially if your condition is diagnosed early. Treatment may include:

• #2 Thoracic Outlet Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557450/

  The interprofessional approach will yield the best patient outcomes in TOS. […] Nursing staff can demonstrate the proper use of braces and splints and answer questions for the patient. They can also monitor progress and inform the clinician of any status changes. […] In surgical cases, nurses and surgical assistants can be invaluable for assisting the surgeon as well as monitoring and providing postoperative care, with PT and rehabilitation to follow.

• #2 Precision Care for Thoracic Outlet Syndrome 

  https://consultqd.clevelandclinic.org/precision-care-for-thoracic-outlet-syndrome

  Patients with TOS typically are referred to pain management from their primary care doctor, physical medicine specialist or a spine surgeon. […] Clinical examination includes having the patient abduct their arms; in TOS patients, this will cause or increase numbness, tingling and sometimes loss of color. […] The second part of the diagnosis includes blocking the anterior scalene muscle and sometimes the pectoralis minor muscle to see if relaxation of these structures relieves the thoracic outlet syndrome pain, says Dr. Abraham. […] Once the block has been performed, patient response is gauged through a pain diary or a verbal report. […] At Cleveland Clinic, however, physicians from a variety of surgical disciplines seek non-surgical options where they make sense, and strive to maximize predictability of surgical outcomes.

• #2 Thoracic Outlet Syndrome | Mount Sinai – New York

  https://www.mountsinai.org/care/surgery/services/vascular-surgery/conditions/other-conditions/thoracic-outlet

  We can also use thoracic outlet decompression if necessary. We have three approaches to this technique: […] Transaxillary approach involves making an incision in your chest and removing a portion of your first rib, to decrease the pressure on your blood vessels. […] Supraclavicular approach involves repairing the narrowed blood vessels by removing muscles and repairing blood vessels. We may also remove your first rib. […] Infraclavicular approach can help us repair narrowed veins. […] Sometimes we combine these techniques with reconstructive procedures of the arteries or veins.

• #2 Thoracic Outlet Syndrome | Frankel Cardiovascular Center | Michigan Medicine

  https://www.umcvc.org/conditions-treatments/thoracic-outlet-syndrome

  Following surgery, patients have a short inpatient hospital stay and then are discharged home, active and able to perform daily activities. During the next few months, a comprehensive physical and occupational therapy program allows patients to resume unrestricted activity. Patients follow a pre-set medication taper regimen so they are off all post-operative medications by six months. […] Following surgery, patients have a short inpatient hospital stay and then are discharged home, active and able to perform daily activities. During the next few months, a comprehensive physical and occupational therapy program to allow patients to resume unrestricted activity. Patients follow a pre-set medication taper regimen so that patients are off all post-operative medications by six months. […] Following surgery, patients have an inpatient hospital stay and then are discharged home, active and able to perform daily activities. During the next few months, a comprehensive physical and occupational therapy program allows patients to resume unrestricted activity. Patients follow a pre-set medication taper regimen such that patients are off all post-operative medications by six months.

• #2 Thoracic Outlet Syndrome Treatment & Management: Acute Phase, Recovery Phase, Maintenance Phase

  https://emedicine.medscape.com/article/96412-treatment

  Physiotherapy focuses on pain control and range of motion with specific stretching exercises. […] Postoperative physical therapy is essential for strengthening and range of motion. […] Continued regular stretching of the muscles around the cervical girdle (eg, scalene, pectoralis major and minor, trapezius, levator scapulae, and sternocleidomastoid muscles) is essential. […] Recommended exercises for thoracic outlet syndrome include neck stretching, abdominal breathing, and postural exercises. […] To help prevent recurrence of thoracic outlet syndrome, the patient should avoid sleeping with his or her arms in an overhead position. […] The patient should avoid repetitive motions, stressful lifting, and overhead work. Performing a regular exercise program for improving flexibility and strength is beneficial.

• #2 Thoracic outlet syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/diagnosis-treatment/drc-20353994

  Your healthcare professional may recommend surgery if conservative treatments haven’t been effective. Or you might consider surgery if you experience ongoing or worsening symptoms. […] Thoracic outlet syndrome surgery has risks of complications, such as injury to the nerves, known as the brachial plexus. Also, surgery may not relieve your symptoms or only partially relieve your symptoms, and symptoms may come back. […] If you’re diagnosed with thoracic outlet syndrome, a physical therapist may instruct you to do exercises at home. The exercises can 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. Create a work area that allows you to keep good posture and doesn’t make symptoms worse. Gently massage your shoulders and thoracic outlet. Apply a heating pad to the area. Practice relaxation exercises such as deep breathing, meditation and stretching.

• #2 Thoracic Outlet Syndrome (TOS): Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17553-thoracic-outlet-syndrome-tos

  Dont wait for your symptoms to go away. Seek medical care if you have symptoms of TOS. While in many cases, conservative measures like physical therapy alleviate symptoms, some people need surgery or other treatments to prevent serious complications. Your provider will tell you the treatment plan thats appropriate for your needs. […] Follow your healthcare providers guidance on how to take care of yourself if you have TOS. Your provider may recommend you: Avoid carrying heavy bags on your shoulder or lifting objects above your head. Work with a physical therapist. Do exercises at home to strengthen your muscles and improve your posture. Modify your daily activities to limit or avoid certain movements that cause symptoms.

• #2 Thoracic Outlet Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/30073

  Overall, the prognosis is excellent in patients with thoracic outlet syndrome. […] Patients who undergo conservative therapy have their symptoms resolve in about 90% of cases. […] Thoracic outlet syndrome (TOS) is a family of conditions in which either the blood vessels or nerves are compressed, resulting in nonspecific symptoms such as numbness, tingling, and weakness in the affected area. […] Non-surgical treatment modalities, such as physical therapy, are the first line of treatment, and patients generally respond well. […] Once TOS is controlled, and the patient is symptom-free, the patient may need to participate in maintenance physical therapy to prevent any relapse of the condition. […] In addition to preventive treatment, patients should not perform any repetitive tasks and avoid overhead lifting as much as possible. […] The interprofessional approach will yield the best patient outcomes in TOS.

• #2 Thoracic Outlet Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK557450/

  Thoracic outlet syndrome (TOS) presents in a vague and nondescript way. […] This activity summarizes the diagnosis and management of patients with thoracic outlet syndrome and highlights the role of the interprofessional team in the care of patients with this condition. […] Describe the interprofessional team strategies for improving care coordination and communication to enhance the care of thoracic outlet syndrome and improve outcomes. […] Physical therapy is a mainstay as first-line treatment for patients suffering from TOS. For many patients, the cause of the condition is muscular imbalance. Physical therapy aims to strengthen the muscles around the thoracic outlet to relieve pressure on the impaired structures. […] Once these complications receive treatment and resolve, the patient must undergo rehabilitation. Much like physical therapy, it aims at strengthening the muscles of the thoracic outlet, but it also encompasses regaining normal function if such function was lost.

• #2 Thoracic Outlet Syndrome (TOS) Causes, Symptoms, Treatments

  https://www.upmc.com/services/heart-vascular/conditions/thoracic-outlet-syndrome

  Thoracic outlet syndrome (TOS) is a disorder that may compress the blood vessels or nerves in the upper chest region. This area called the thoracic outlet is behind and below the collarbone opposite the first rib. […] At UPMC, we take a team approach to quickly and correctly diagnosing TOS. Then, we’ll create a treatment plan that’s right for you. […] TOS can occur on either side of the body but most often affects your dominant hand’s side because of constant use. […] Early diagnosis and treatment of TOS are key to reducing the risk of complications and delivering a successful treatment outcome. Your prognosis will depend on the type of TOS you have, as well as the severity of your condition. […] Vascular surgeons at UPMC offer a range of treatments for arterial, venous, and neurogenic TOS.

• #3 Thoracic Outlet Syndrome | Nurse Key

  https://nursekey.com/thoracic-outlet-syndrome/

  1. Identify nursing implications relevant to patients with thoracic outlet syndrome. […] […] 2. In the absence of a specific gold standard test for TOS, an accurate clinical history and evaluation are paramount in assessing patients. […] […] 3. Nursing interventions include assessing pain level on a specific scale, identifying aggravating and alleviating factors, and setting pain level targets with patients. […] […] 4. Reinforce physical therapy exercise programs. […] […] 5. Encourage participation by family members/significant others in the process. […] […] 6. Evaluate sleep patterns and provide measures to induce sleep, such as soft music and proper positioning at night. […] […] 7. Assess current knowledge level regarding disease processes, treatment options, and pain control. […]

• #3 Thoracic outlet syndrome – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/diagnosis-treatment/drc-20353994

  Diagnosing thoracic outlet syndrome can be challenging. Symptoms can vary greatly among people. Your healthcare professional may review your symptoms and medical history and conduct a physical exam. You also may need imaging and other types of tests. […] Physical therapy is the first line of treatment. The exercises strengthen and stretch your shoulder muscles to open the thoracic outlet. This improves your range of motion and posture. These exercises, done over time, may take the pressure off the blood vessels and nerves in the thoracic outlet. […] If you have neurogenic thoracic outlet syndrome, physical therapy is the first line of treatment. The exercises strengthen and stretch your shoulder muscles to open the thoracic outlet. This improves your range of motion and posture. […] A conservative approach to treatment may be effective for most people, especially if your condition is diagnosed early. Treatment may include:

• #4 Thoracic Outlet Syndrome | Nurse Key

  https://nursekey.com/thoracic-outlet-syndrome/

  1. Identify nursing implications relevant to patients with thoracic outlet syndrome. […] […] 2. In the absence of a specific gold standard test for TOS, an accurate clinical history and evaluation are paramount in assessing patients. […] […] 3. Nursing interventions include assessing pain level on a specific scale, identifying aggravating and alleviating factors, and setting pain level targets with patients. […] […] 4. Reinforce physical therapy exercise programs. […] […] 5. Encourage participation by family members/significant others in the process. […] […] 6. Evaluate sleep patterns and provide measures to induce sleep, such as soft music and proper positioning at night. […] […] 7. Assess current knowledge level regarding disease processes, treatment options, and pain control. […]

• #5 Thoracic Outlet Syndrome | Nurse Key

  https://nursekey.com/thoracic-outlet-syndrome/

  1. Identify nursing implications relevant to patients with thoracic outlet syndrome. […] […] 2. In the absence of a specific gold standard test for TOS, an accurate clinical history and evaluation are paramount in assessing patients. […] […] 3. Nursing interventions include assessing pain level on a specific scale, identifying aggravating and alleviating factors, and setting pain level targets with patients. […] […] 4. Reinforce physical therapy exercise programs. […] […] 5. Encourage participation by family members/significant others in the process. […] […] 6. Evaluate sleep patterns and provide measures to induce sleep, such as soft music and proper positioning at night. […] […] 7. Assess current knowledge level regarding disease processes, treatment options, and pain control. […]

• #6 Thoracic Outlet Syndrome | Nurse Key

  https://nursekey.com/thoracic-outlet-syndrome/

  1. Identify nursing implications relevant to patients with thoracic outlet syndrome. […] […] 2. In the absence of a specific gold standard test for TOS, an accurate clinical history and evaluation are paramount in assessing patients. […] […] 3. Nursing interventions include assessing pain level on a specific scale, identifying aggravating and alleviating factors, and setting pain level targets with patients. […] […] 4. Reinforce physical therapy exercise programs. […] […] 5. Encourage participation by family members/significant others in the process. […] […] 6. Evaluate sleep patterns and provide measures to induce sleep, such as soft music and proper positioning at night. […] […] 7. Assess current knowledge level regarding disease processes, treatment options, and pain control. […]

• #7 Thoracic Outlet Syndrome | Nurse Key

  https://nursekey.com/thoracic-outlet-syndrome/

  1. Identify nursing implications relevant to patients with thoracic outlet syndrome. […] […] 2. In the absence of a specific gold standard test for TOS, an accurate clinical history and evaluation are paramount in assessing patients. […] […] 3. Nursing interventions include assessing pain level on a specific scale, identifying aggravating and alleviating factors, and setting pain level targets with patients. […] […] 4. Reinforce physical therapy exercise programs. […] […] 5. Encourage participation by family members/significant others in the process. […] […] 6. Evaluate sleep patterns and provide measures to induce sleep, such as soft music and proper positioning at night. […] […] 7. Assess current knowledge level regarding disease processes, treatment options, and pain control. […]

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