Thoracic outlet syndrome occurs when the blood vessels or nerves in the thoracic outlet (the space just under the collarbone) become compressed. This can cause pain in the shoulders and neck and numbness in the fingers. The symptoms vary depending on whether it is the nerves or the blood vessels that are affected. When the nerves are compressed, symptoms usually include numbness or tingling in the fingers, pain in the shoulder and neck, ache in the arm or hand, and weakened grip. When a vein or artery is compressed, symptoms can include bluish discoloration or lack of colour in the hand, a blood clot under the collarbone, arm pain and swelling (possibly due to blood clots), a throbbing lump near the collarbone, weak or no pulse in the affected arm, and tiny, black spots (infarcts) on the fingers.
Thoracic outlet syndrome may develop from a variety of causes. Physical trauma from a motor vehicle accident, repetitive stress injury from work or sports, anatomical defects such as having an extra rib, poor posture, and pressure on the joints due to body weight or because of carrying an oversized backpack or purse can all lead to thoracic outlet syndrome. Even a long-ago injury can lead to thoracic outlet syndrome in the present, as can pregnancy, because of the joints loosening. In some cases, the cause of thoracic outlet syndrome cannot be determined.
Treatment for thoracic outlet syndrome usually involves a combination of exercises, relaxation, and medications. Physiotherapy is used to open the thoracic outlet, improve range of motion and posture, and strengthen the shoulder muscles. Relaxation techniques may help to reduce tension in the shoulders and maintain posture. Medications such as muscle relaxants, anti-inflammatories, and pain medications may be prescribed for pain relief. In severe cases where the syndrome does not improve, surgery may be recommended.
Acupuncture is also an option worth considering for thoracic outlet syndrome. Acupuncture is a well-known therapy for pain relief and for musculo-skeletal conditions. Chinese medicine (TCM) does not use the term “thoracic outlet syndrome”, diagnosis instead depends on the specific symptoms that an individual is presenting. Typically thoracic outlet syndrome will be categorised as an injury to the tendon, a bi-syndrome (pain caused by a blockage in one of the body’s meridians and a lack of circulation of qi-energy and blood to the area), or a wei-syndrome (weakening and evening atrophying of a muscle due to a lack of proper nutrients or blood and qi-energy circulation). Depending on the type, the specific symptoms will vary but may include pain, numbness and heaviness of the muscles, tendons or joints, tendon or joint swelling, limitation of movement, and weakness in the limbs.
Acupuncture can help with thoracic outlet syndrome in a number of ways. Acupuncture of course offers very effective pain relief, and it can also reduce inflammation and relax tight muscles or tendons to relieve pressure to the nerve or tendon. Treatment also helps to remove blockages and increase blood circulation and energy, so that the area can receive adequate nourishment to function properly and to heal. Acupuncture can also resolve any imbalances in the meridians that may be causing a weakness in the body, leaving an area prone to injury or strain, as is often the case when a condition develops.
In my practice, I have seen thoracic outlet syndrome respond very positively to acupuncture. A series of treatments can offer relief of symptoms and can help to resolve the condition, depending on the cause. Stretching and postural exercises are also important and can help support recovery from this syndrome.
James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, downtown Kelowna. He can be reached at www.okanaganacupuncture.com.