ChiroACCESS Clinical Review



Thoracic Outlet Syndrome: Prevention

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Lead Author(s): 

Dwain M. Daniel, D.C.

  

How this evidence was rated:

Strength of Recommendation Taxonomy (SORT)



Published on

July 19, 2010

Text Size:     
Risk factors and prevention strategies for thoracic outlet syndrome (TOS) are very difficult to access for a number of reasons.  Since its introduction as a diagnostic term in 1956 (1) the diagnosis itself has remained controversial with some doubting the clinical entity even exists (2).  Thoracic outlet syndrome has become an umbrella diagnosis that includes scalenus anticus syndrome, cervical rib syndrome, costo-clavicular syndrome and  hyperabduction syndrome, to name just a few (3).  Additionally the diagnosis is primarily a clinical diagnosis since examination, electrodiagnostic and imaging findings have low specificity and sensitivity (4).  Finally few clinical trials have examined efficacy of TOS interventions, much less prevention strategies.  As a result risk factors and prevention strategies identified are based on weak evidence and are largely expert opinion.

The reported incidence of TOS covers a broad range, from 0.3% to 8%, and is reflective of the uncertainty of the diagnosis (5).

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References

1. 

PEET RM, HENRIKSEN JD, ANDERSON TP, MARTIN GM. Thoracic-outlet syndrome: evaluation of a therapeutic exercise program. Proc Staff Meet Mayo Clin 1956 May 2;31(9):281-7.



2. 

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3. 

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Vanti C, Natalini L, Romeo A, Tosarelli D, Pillastrini P. Conservative treatment of thoracic outlet syndrome. A review of the literature. Eura Medicophys 2007 Mar;43(1):55-70.



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12. 

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Priest JD. The shoulder of the tennis player. Clin Sports Med 1988 Apr;7(2):387-402.

 [ Medline ID 3390873 ]

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Richardson AB. Thoracic outlet syndrome in aquatic athletes. Clin Sports Med 1999 Apr;18(2):361-78.

 [ Medline ID 10230571 ]

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Dugas JR, Weiland AJ. Vascular pathology in the throwing athlete. Hand Clin 2000 Aug;16(3):477-85, x.

 [ Medline ID 10955220 ]

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Sanders RJ, Hammond SL, Rao NM. Thoracic outlet syndrome: a review. Neurologist 2008 Nov;14(6):365-73.



20. 

Nichols AW. Diagnosis and management of thoracic outlet syndrome. Curr Sports Med Rep 2009 Sep;8(5):240-9.