Introduction
- The Thoracic outlet condition is a complication which affects the blood vessels and nerves which are found in the thoracic outlet.
- The thoracic outlet, which is one of the most sensitive and delicate parts in the human body contains tissues and bones.
- During compression of the blood vessels, muscles and nerves in this part of the body, there is a pain in the neck and shoulder that is experienced by the affected person and is simply due to compression of the first rib and the collarbone.
- There are often several types of Thoracic outlet condition, but the three common ones are vascular, non-specific and neurologic Thoracic outlet conditions.
Causes
- Because the Thoracic outlet condition is a condition which affects the thoracic outlet, any condition or movement which may cause the tissues near this part of the body to enlarge or move in any direction can cause the condition.
- The causes of the conditions and movements of the Thoracic outlet include activities such as weight gain, lifting heavy materials, lung tumors and experiencing cervical ribs.
- Injuries in the work place as well as car accidents are also a common cause of Thoracic outlet condition.
Cause cont’d
- The most common symptoms of the Thoracic outlet condition include pain and numbness which are experienced in the neck, shoulder and in the arm.
- Often this pain can extend to the hands and the fingers so that the patient experiences problems in handling some things by using the hand.
- The effect on the hand however depends on the nature of the injury which had been done to the Thoracic outlet.
Diagnosis
- When an individual is found to have Thoracic outlet condition, the diagnosis is often done depending on the conditions which he exhibits during that particular time.
- The doctor will therefore look at the findings and the picture which the patient shows.
- The conditions which patients may exhibit may differ, depending on the type of condition.
Diagnosis cont’d
- The Neurological Thoracic outlet condition for instance, is characterized by pain in the neck and shoulder, aching in the hand and arm, weakening of the grip of the hand and tingling of the fingers.
- Thoracic outlet condition patients can also show different symptoms depending on the compression of structures.
- Patients with vascular Thoracic outlet condition on the other hand exhibit conditions such as throbbing lump near the collarbone, the hand discoloring and becoming bluish and developing black spots on the hands and arms.
Testing
- So as to cure patients with Thoracic outlet condition, specialized testing is often done. This process involves the use of radiographs of the cervical spine and chest. This is done so as to remove the degenerative changes which occur in the cervical spine and causing shoulder and neck pain.
- Radiology is also helpful in identifying cervical ribs which may lead to identifying those which have been affected by plexus injuries and fibrous bands. This will thus lead the doctor to give a specialized treatment.
- Radiological test if done by the doctors so as to recognize intrusion of the spinal nerve root and therefore assisting the doctor to be in a position to eradicate the likelihood of lobe lung masses.
Testing cont’d
- These tests are often used by the doctor in finding out the cervical root injury and differentiating it with herniation of degenerative discs and its causes.
- The use of the MRI testing is to find out the distortion and misplacement of plexus in the Thoracic outlet and thus be able to understand the nature of the injury.
- This process can also involve plethysmography and Doppler studies, which is an important technique in finding the nature of flow of blood and its interruption in the Thoracic outlet.
Testing cont’d
- Another specialized method of testing patients with Thoracic outlet condition is the use of electro diagnostic studies. These studies are important in finding out the true neurogenic thoracic outlet syndrome and thus be in a position to rule of any other sites of compression which may have occurred.
- Electrical tests on the other hand are often utilized by the doctor so as to find out the extent of the effect on the nerves between the hand and the neck.
- Research indicates that special tests of the blood vessels can also be done in a testing center by a professional in order to check whether the person suffers from Thoracic outlet condition.
- The intensity of the injury often determines the extent of the injury of the nerve. Specialists would therefore look at the nature of activities that an individual has often even involved in and therefore conclude the nature of the problem.
Prognosis
- Prognosis if often done for most cases of Thoracic outlet condition, as long as they are not severe, but if the condition has gone too far, surgery is often recommended.
- When prognosis id doe, it may yield success to some patients, though for some cases it may not.
- Many of the affected patients will get some relief from numbness and parathesias by gaining strength which had been lost and tolerating activities which they could not do.
- Some of the patients will develop disability or experience chronic pain and in some cases disability which can be psychological or physical.
- When there is assumption of activities which may lead to onset of symptoms, this condition may likely recur in a patient.
- Strengthening and posture corrections are often very important so that the patient will have a continued improvement from this condition.
Physical therapy
- Therapy plays a very significant role in the treatment of Thoracic outlet condition. Although considered as traditional methods, strengthening and stretching of the muscles, mobilizations of joints and doing exercise can help in restoring the loss of motions which may cause this condition.
- Breathing, ethafoam roller exercise and aerobic exercise also play a very crucial role in accomplishing the treatment of Thoracic outlet condition.
Physical therapy cont’d
- Specialists often advise that exercises and motions are very important for patients who are suffering from Thoracic outlet condition.
- Methods of exercises like Feldenkrias has been found out to help patients especially those suffering from Thoracic outlet condition to successfully heal.
- Although the patients need to do exercises, they are also advised not to participate in exercises which are strenuous. These exercises include lifting heavy weights and painful stretching.
The role of a physical therapist
- It is very important that patients need to be tested so that the conditions which have caused the Thoracic outlet condition can be corrected.
- The physical therapist is very important in this situation because they can help in the restoration of the pain relief, mobility and therefore limit physical disorders that may be permanent.
- Physical therapists can utilize the use of electrical simulation, cold compressors, ultra sound equipment and hot packs in reducing swelling and relieving pain.
- These specialists will engage in using the patient’s muscles in increasing their flexibility.
The role of a physical therapist cont’d
- They would also record the progress and conduct examinations periodically so as to ensure proper modification and delivery of care to Thoracic outlet condition patients.
- These specialists further use depend tissue massage and traction so as to relive pain into eh Thoracic outlet condition patients.
- They help the patients by utilizing assistive devices such as crutches, wheelchairs and prostheses.
- Exercise is thought to be very important since they aid the patients at home to recover.
Conclusion
- So as to heal patients with Thoracic outlet condition, it is important to utilize the thoracic therapy process.
- If patients suffering from Thoracic outlet condition are left without attending to them, they may develop a permanent physical disability.
- Many people are thought to have this condition without their knowledge because many people do not often go for treatment and checkup.
- It is very important that professionals and doctors should address this problem so that patients can be healed.
References
- Diane V. J (2010) Guide To Evidenced Based Physical Practice: Johns & Bartlett learning Inc: Massachusetts.
- Kathleen A. C.(1999) The Physical Therapist Guide To Health Care. Slack Incorporated: Massachusetts.
- Robert G. S. (2006). Resolving Complex Pain.USA: Piedmont Physical Medicine &Rehabilitation.
- Thomas W.S. (2009) General Thoracic Surgery Lippincott Williams and Wilkins: New York.
