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Treating Thoracic Outlet Syndrome

How Thoracic Outlet Syndrome is Treated


Treating thoracic outlet syndrome typically starts with physical therapy and preventative measures. Treatment with medication is limited but may help. If your symptoms of thoracic outlet syndrome are not lessening through your physical therapy then surgery may be needed to open up the thoracic outlet.

Prevention of Thoracic Outlet Syndrome

Recovery will be slow or ineffective if the repetitive stress that caused or aggravated your thoracic outlet syndrome is taken care of. Therefore preventing thoracic outlet syndrome is one of your first steps.

Preventing thoracic outlet syndrome can be as complicated as the constellation of disorders that make up the syndrome itself. Generally speaking, preventative measures revolve around maintaining a good posture while a nice S-curve to the spine and an open chest to keep compression of the thoracic outlet to a minimum. Ensuring that your posture is not static is another concern.

Good posture while you work, play and even sleep is necessary to treat thoracic outlet syndrome. Frequent breaks when a position needs to be held are also necessary. You should also avoid lifting or carrying heavy objects.

Physical Therapy

Physical therapy is used to try to open up the thoracic outlet and reduce the compression on the subclavian artery, the subclavian vein or the brachial plexus. It also serves to strengthen muscles to help hold you is a good posture.

Various stretches focus on elongating and relaxing specific muscles that have a connection to the thoracic outlet such as the shoulder, neck and upper chest. Stretching these muscles out can reduce the stress on the thoracic outlet and help it relax into an open position.

Exercises are done with and without weights to strengthen certain muscles and aid in stretching out others to pull the thoracic outlet into an open position. When the thoracic outlet is sufficiently opened then all compression is gone and your symptoms should be gone. However your symptoms may soon return due to poor posture and bad habits that have unbalanced your muscles so they easily fall back into pulling your thoracic outlet closed and compression returns. Physical therapy endeavors to rebalance your muscles to keep your chest in a posture that keeps your thoracic outlet open. Relaxation techniques such as deep breathing and meditation can aid in opening up the thoracic outlet. Yoga, which combines deep breathing, stretching and posture retraining ,ay also be beneficial.

Physical therapists may have specialized training for working with thoracic outlet syndrome. If you need physical therapy you should ensure that your therapist is knowledgeable about the condition and can gauge your progress throughout your therapy. The physical therapist will guide you through exercises and can teach you some you can do at home by yourself to use for preventing thoracic outlet syndrome.


Pain medication and muscle relaxants are the main drugs used to treat thoracic outlet syndrome. Pain medication usually just helps manage your pain symptom. However, if it is also a muscle relaxant, blood thinner or anti-inflammatory it may also help address a cause of your thoracic outlet syndrome. Medication alone is normally ineffective and should be coupled with physical therapy.


Surgery is usually an option for treating thoracic outlet syndrome in three cases. In the first case treatment through surgery may come during an exploratory surgery when diagnosing thoracic outlet syndrome. If your case of thoracic outlet syndrome has proved severe enough to warrant cutting you open to find out the cause it is usually prudent to go ahead and fix it before they stitch you up.

In the second case a positive diagnosis has been made and your symptoms are severe enough that the risks of surgery outweigh the risks of damage to your arms and shoulders due to severe neurological or vascular compression. Muscle atrophy and blood clots are some symptoms of thoracic outlet syndrome that can cause severe damage to your body and may need to be aggressively treated. Permanent nerve damage is also a significant risk with thoracic outlet syndrome.

In the third case your symptoms have not responded to physical therapy and surgery may be the only option left to you to get some relief. Often this is the result of some anatomical anomaly or neurovascular entrapment that can only be treated through surgery, such as removing a cervical rib. Surgery to treat thoracic outlet syndrome is risky. It involves both a major nerve bundle and major blood vessels. Complications may be life threatening. As such you should thoroughly discuss the risks of surgery with your doctor before hand

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