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JACA Online Results
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By Angela Kargus Thoracic Outlet Syndrome J Amer Chiropr Assoc 2008 Dec;45(9):34-35 |
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With this patient education article, your patients can learn about causes and symptoms of thoracic outlet syndrome, as well as currently accepted treatments. Of particular interest is a brief section on helpful home exercises.
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Neil Cohen, DC Non-Operative Care of a Patient with Thoracic Outlet Syndrome and Cervical Radiculopathy: a Case Report J Amer Chiropr Assoc 2005 July;42(5):9-13 |
Objective: To discuss the diagnosis and treatment of a patient with neck and upper-extremity pain after trauma due to thoracic outlet syndrome. The conservative treatment in a multidisciplinary center with interventional physiatric procedures and chiropractic rehabilitation protocols was successful.
Clinical Features: A 56-year-old right-handed female employed as a charge nurse who had been involved in 2 motor vehicle accidents (MVAs) reported headaches and neck, bilateral arm and shoulder pain which was much worse on the left than on the right. MRI demonstrated C3-6 degenerative disc disease with C3-4 protrusion and C4-5 and C5-6 bulging. Nerve conduction studies showed slowing bilaterally of the median nerve conductions through the carpal tunnel, and slowing of the ulnar nerve conductions through the elbow. The patient was then referred to a vascular surgeon who performed arterial volume studies. The studies revealed abnormal arterial blood flow through both subclavian arteries with hyperabduction of the arms.
Intervention and Outcome: The patient had initially been treated by the center's physiatrist who performed cervical epidural injections and facet injections that improved her complaints of neck and arm pain. She was then treated with rehabilitation focusing on muscular imbalances, including tight muscles with trigger points and other muscles with weakness. Postural deficits were identified. The abnormal posture and muscular dysfunctions were addressed with muscle stretching, relaxation and therapeutic exercises. The patient responded well to treatment and was released with good long-term outcome.
Conclusion: Conservative rehabilitation by a doctor of chiropractic, combined with physiatric interventional procedures in a multidisciplinary approach, can provide patients with successful treatment for injuries. Thoracic outlet syndrome, combined with cervical spine joint, disc and nerve root injuries, offer opportunities for this team approach.
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Case Question: Thoracic Numbness J Amer Chiropr Assoc 2003 Oct;40(10):48-49 |
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A 53-year-old male patient with mid-thoracic pain is complaining of a numb sensation by the right shoulder blade (T5-6). No history of specific trauma, but the mans work is physically demanding. Has a history of sinus infections and severe acid reflux (non-responsive to medications).
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Kim McKenzie, ND, DC, Gene Lin, DC, and Shai Tamir, DC Thoracic Outlet Syndrome. PART I: A clinical review J Amer Chiropr Assoc 2004 Jan;41(1):17-24 |
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Thoracic outlet syndromes (TOS) describe a group of disorders that refer to compression of the brachial plexus or the subclavian vessels as they pass through the thoracic outlet. Ninety percent of TOS patients' complaints are neurological in nature. These syndromes can be named according to the location of compression or the cause of symptoms. Many factors predispose patients to the development of TOS, such as occupation, gender, medical conditions, and genetic anomalies. Diagnosis is largely based on the history and physical examination findings. Most patients respond well to conservative care, but success in conservative management depends on an accurate assessment and development of a treatment plan specific to the patient's needs.
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Thoracic Outlet Syndrome: Puzzling J Amer Chiropr Assoc 2004 Jan;41(1):8-16 |
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Whether you call it cervical axillary syndrome or thoracic outlet syndrome, what exactly is it, how might a doctor of chiropractic diagnose it (and differentiate it from conditions that manifest similarly), and how is it treated? The article helps answer the questions.
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