Physiotherapy and rehabilitation approaches in thoracic outlet syndrome

Abstract

Physiotherapy and rehabilitation is always the first choice in the management of Thoracic Outlet Syndrome (TOS). Due to difficulty to make objective diagnosis or making the diagnosis behind time despite obvious clinical features, physiotherapy approaches should include causative factors and protective approaches than symptomatic treatments.Creating approaches oriented causative factors for TOS is more important while postural modifications, patient education, strengthening and stretching exercises seem as basic approaches. The basic aim in conservative management is to remove extrinsic compression with decreasing the irritation of peripheral nerves. Moreover, to offer methods to treat TOS as well as decreasing compression in the neurovascular structures.Assessment should include sensory and motor symptoms which induced by neural and vascular compressions. Posture assessment, muscle imbalance, muscle shortness and flexibility, respiratory assessment and pain assessments are performed in this manner.Conservative treatment approaches can be ranged to gain the diaphragmatic breathing pattern, to decrease inflammation, to relieve the soft tissues with tension, to provide muscle balance, to maintain neural excursion, to improve posture and body mechanics and to provide the spinal stabilization. In accordance with these basic aims, physiotherapy and rehabilitation can be planned as 3 stages: Preventative phase, restorative phase and rehabilitation phase.