Thoracic Outlet Syndrome

[ColoredHares]

I have recently been diagnose with Thoracic Outlet Syndrome and am wondering if this could have been caused by previous injuries. I have had the symptoms for the last 2 1/2 years. Anyone else have this? And if so, what are you doing, or did you do to relive the symptoms?

This is the definition : Thoracic outlet syndrome is a rare condition that involves pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collarbone.

These are the causes: Blood vessels and nerves coming from the spine or major blood vessels of the body pass through a narrow space near your shoulder and collarbone on the way to the arms. Sometimes, there is not enough space for the nerves to pass by or through the collarbone (clavicle) and upper ribs.

Pressure (compression) on these blood vessels or nerves can cause symptoms in the arms or hands. Problems with the nerves cause almost all cases of thoracic outlet syndrome.

Pressure may happen if you have:

An extra rib, above the first one
An abnormal tight band connecting the spine to the ribs.
People with this syndrome often have injured the area in the past or overused the shoulder.

People with long necks and droopy shoulders may be more likely to develop this condition because of extra pressure on the nerves and blood vessels.
I know that my posture is not the issue, riding has made sure of that!

[Desert_Topaz]

I’ve got it. Probably because of bad posture from a neck injury and too much typing. It can be exacerbated by having your arms high, so if I groom tall horses my arms don’t work afterwards.

What has helped: a medical massage therapist that can massage the crap out of the area with the impinged nerves. It hurts, oh does it hurt, but then the arms don’t hurt and actually work properly for awhile, so I put up with it. I have also done PT on and off, which in theory should have helped, but didn’t because of my other neck issues.

[Desert_Topaz]

Also, for the grip issues it’s all about SSG All Weather Gloves and Thin Line reins for me.

[sdlbredfan]

Hmm…I wonder if that is why I sometimes have some intermittent finger numbness that resolves spontaneously. I am a few years post median sternotomy for heart surgery. I am sorry to read of folks that have this, but am encouraged to know there is a name for this.

[Twigster]

I was diagnosed with this in high school. I had problems with what they thought was carpal tunnel and radial tunnel, but after surgery to fix those offered only minimal relief they looked higher up.

I had to give up a lot of things, I used to play violin semi professionally and rock climb several days a week. Now I climb a few times a year and play violin rarely. At least I can still ride!

There is a first rib mobilization technique you can do with a wide piece of cotton belt material, it’s very helpful. Keeping your back, chest and an muscles strong is helpful and so is a good massage therapist.

I’d def ask a PT to teach you he first rib mobilization. And maybe biofeedback to relax the trapezius area.

[Logical]

I too have been diagnosed as having this. I’m still not 100% sure that is indeed the case but the symptoms fit. Doctors and I suspect that the fall of my first horse back in 1998 (where I landed on my shoulder blades) was/is the cause of my problems. I now take 300mg of Gabapentin once a day to help ignore improper nerve pulses. However, it seems to not be working as well anymore and I hate the idea of increasing the medication when I’m not comfortable with the lack of tests done to confirm this diagnosis.

What has helped me is massage therapy, however my insurance limited me to 20 visits per coverage year. I only have 3 visits left until October. So I’m saving them for when I absolutely need them. I can’t afford a massage therapist on my own ($60/hour).

I am curios on what tests others had done? All they have done to me is a nerve conduction test (2x) and an x-ray on my wrist.

[ColoredHares]

Thanks for your input!
Logical, I had the nerve conduction studies done and they showed carpal tunnel and ulnar nerve compression. The folks at Shands wanted to do the ulnar nerve surgery, but I was already doing PT, for the shoulder weakness/pain, and my therapist was convinced it was further up. I also had an MRI of my neck and the thoracic outlet test of an ultrasound. The ultrasound was what made the diagnosis. The test compares the two arms in the same positions with pressure cuffs and w/o. The test is looking for constrictions or ‘flatlines’ in the readings.
i think massage therapy and stress reduction exercises are needed! The only other causes (that I have been told) is that there could be a blood clot causing the compression. I am seeing a vascular surgeon next. Given the feedback I have heard about the surgery, that will be the very last option…
i will have to ask about the Gabapentin. Thanks!

[Logical]

Hmmm. My first nerve conduction test showed ‘nothing’ and the doctor told me it was intermittent ulnar nerve entrapment. Another year goes by and I make it to my family doctor while my arm is swollen. They send me to a specialist 3 hrs away that does an X-ray on wrist which comes back clean and he says do pain management. (Hello a-hole I’m not even close to 30!) So another nerve conduction test is done. That doctor goes higher and finds a delayed impulse between thoracic and elbow but not coming the ulnar nerve path. Diagnosis made and pills prescribed. I’ve gained weight from the Gabapentin (which already struggling with weight doesn’t help). And now it looks like the dose might need to be upped which if I’m upping every two-three months what good is it?

I plan on pushing for more tests at least an MRI next appointment. A friend of mine had a cyst that once removed relieved all symptoms. Good luck.

On phone so I apologize for any typos.