St. Paul Chiropractor Blog

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Arm/Shoulder Pain and Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a condition in which there is compression of the nerves, arteries, or veins in the passageway from the lower neck to the armpit. The most common type of presentation is pain, weakness, and occasionally loss of muscle at the base of the thumb.

One potential cause of thoracic outlet syndrome is compression of tight muscles on the nerves and blood vessels traveling down the arm. The Pectoralis Minor muscle (see picture) can become shortened and tight. Because of its close proximity to the nerves and blood vessels of your arm, this may cause TOS as these structures become pinched or pressed underneath the muscle. Postural tension is often the source of Pec minor tightness.  Sitting at a computer or desk all day long causes the neck to travel forward and shoulders to roll forward. This shortens the muscle leading to the unwanted tightness.

Those lacking a movement practice that opens up the shoulder girdle and restores proper function to the shoulder may begin experiencing symptoms of thoracic outlet syndrome over time.  This may include numbness or tingling, pain and weakness or a discomfort that comes and goes.  

Chiropractic Treatment for Thoracic Outlet Syndrome

Accurate assessment is necessary before beginning treatment.  Often times the pulse will be felt to diminish when the arm is raised. This can be a good test to determine if the Pec Minor is contributing to the symptoms.  In this case, the examiner will check the pulse at the wrist and slowly raise the patient’s arm. If the pulse disappears or diminishes significantly, it is a sign that the Pec Minor is compressing the blood vessels as it tightens due to the raising of the arms.  Correlating this with the other clinical findings can be very helpful in finding the cause.

Often times there will be associated findings such as misaligned vertebrae (subluxations). These vertebrae are dysfunctional due to the same postural stresses or accumulated stresses and may be lacking the proper mobility needed to allow full function in the neck and shoulder.  In addition, the spinal dysfunction is causing further nerve compromise and faulty biomechanics.

To correct a spinal subluxation, a chiropractic adjustment is needed. This is a specific force in a specific place by the chiropractor in order to restore function.  Chiropractic adjustments to dysfunctional joints in the shoulder, neck and upper back restore range of motion and release the stored postural tension.

Stretching – including Active Release Therapy (ART) – is helpful to release adhesions in the muscle fascia. Trigger-point muscle work may be helpful to restore balance to the muscle tension as well.  Kinesiotaping to the muscles, tendons and joints can provide support in some cases when muscles are overworked or damaged and also may help promote healing if there is congestion in the tissues.  The elastic nature of the tape provides a flexible, yet stable support which helps overall function.

While stretching is helpful, it may yield only temporary relief.  Until the underlying joint dysfunctions are corrected, it likely will be a recurring problem any time these muscles are stressed.  Corrective exercises are often necessary for long term resolution of this painful condition.  Assessing which muscle groups are weak or inactivated can help direct the proper exercises to perform. Often times this starts with restoring mobility to the entire shoulder girdle. Only then can strength be developed safely and effectively.

If you or someone you know is dealing with arm/shoulder pain – give us a call or schedule online!

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