What is Thoracic Outlet Syndrome?

I've got WHAT?

After weeks of playing phone- and text-tag, my bestie and I FINALLY got to chat for a few minutes this morning. (Besides the President she's the busiest person I know.) Since we only had about 10 minutes' worth of chat time, we had to cram in all that's been going on with us lately into a quick conversation.

I was telling her about this-and-that when it hit me that she didn't know a big thing that's been happening in my life recently. I told her, "Oh, and lately my arms have been really painful and I can't hold onto things – like my mouse or the steering wheel – for very long periods of time and sometimes I'd just lie down and try to keep my arms still and cry because of the pain." She gave a gasp and said, "Whoa, what the heck is wrong with you?"

Well, that WAS the question in question a few weeks back...I seriously thought my mid-thirties were just creeping up on me and trying to single-handedly end my active lifestyle. I mean, I already fight the effects of having two disc herniations; why was I being plagued with yet ANOTHER major bodily defect? And, more importantly – what WAS the issue?

Enough is Enough (is Enough is Enough)
After one of the lying-on-the-couch-crying episodes I figured enough was enough and made an emergency visit to my chiropractor. I tearily told her my symptoms (and all the things I couldn't do lately because of the pain) and she performed a few physical tests. One of which involved me putting my arms up at shoulder height, then bending my elbows into Ls and opening and closing my hands as quickly as I could – I was supposed to do this exercise for 60 seconds; I made it to 10 before I told her, "I just can't do this anymore," it hurt that badly.

She then had me quickly lower my arms so my hands were below my waist, palms-up...and I stared in shock at my WHITE hands. Slowly, the left hand started to turn slightly pink; the right steadfastly remained WHITE. The chiropractor, looking on, merely said, "Oh. Well then." Freaked out, I asked, "What's going on??" She replied, "Well, you're not getting enough blood in your arms. This is the clearest case of thoracic outlet syndrome I've ever run across."

This wasn't an entirely strange diagnosis; one of my other chiropractors had mentioned I could have symptoms of TOS a couple of years ago, when I'd wake up in the middle of the night with one arm entirely devoid of life...but I'd done some stretching and gotten a couple treatments and had been fine. Or so I'd thought. Evidently I hadn't kicked thoracic outlet syndrome; it'd started rearing its ugly head yet again...but in such a different manner I hadn't even considered that to be the issue.

What is thoracic outlet syndrome (TOS)?

So, what in hell is thoracic outlet syndrome, anyway? Well, according to Mayo Clinic, TOS is:

Thoracic outlet syndrome is a group of disorders that occur when the blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) become compressed. This can cause pain in your shoulders and neck and numbness in your fingers. 

The American Academy of Orthopaedic Surgeons breaks thoracic outlet syndrome down into symptoms for the two categories:

Pressure on the nerves (brachial plexus) may cause a vague, aching pain in the neck, shoulder, arm, or hand. It may also cause pain, numbness, or tingling on the inside of the forearm and the fourth and fifth fingers of the hand. Weakness may make your hand clumsy.

Pressure on the blood vessels can reduce the flow of blood out of your arm, resulting in swelling and redness of your arm. Less commonly, pressure can reduce the blood flow into your arm and hand, making them feel cool and easily fatigued.

My chiropractor had said my problem was blood flow restriction, so I obviously fit into the latter category as I was experiencing pain and numbness throughout both my arms and hands; there was no evidence of pinpointed tingling in any fingers or parts of my arms. (I also have very cold hands – just ask my husband.)

What's the prognosis of my TOS?

She tested out the muscles in my neck and chest – near my clavicle – and promptly went to work on that area to loosen up all the tightness. She gave me a few stretching exercises to be performed daily – as often as I wanted to – and also told me I need to really pull my shoulders back. Because of my back issues I have pretty good posture (I'm very aware of engaging my core at all times), but it seems I was letting my shoulders crumple forward – partially due to the tightness in my pec muscles – and that was only exacerbating the problem.

So, I'm to continue stretching out my pecs and neck muscles, along with my forearms/wrists, etc., all while focusing on keeping my shoulders back. Oh, and not crunching my shoulders when I sleep, either. And trying to keep my neck aligned properly on my pillow. OH, and of course while doing my core- and glute-strengthening exercises every day. *sigh* Getting old sucks.

What Causes TOS?
Finally, what caused my TOS? Who knows is the best guess. I mentioned I've been having neck muscle tension problems while sleeping since I was 13 years old...the chiro asked, "Were you in a car accident as a kid?" I replied, "No...but I fell off my horses quite a bit – once, about the year my neck problems started, I fell of my mare and got knocked out."

"Well, that could do it," she said...but of course who really knows for sure. The point is, I've been diagnosed, I know what's going on and how to combat it. The problem is trying to work through this issue when I've been suffering from it for so long...now I have to basically break down scar tissue from who-knows-when.

Here are a couple of videos explaining thoracic outlet syndrome and also several exercises to help with the symptoms...let me tell you, something so easy as straightening out your arm at shoulder height and moving your neck shouldn't seem hard – but I could barely make it through TWO reps of each of these exercises!





So there you have it. Thoracic outlet syndrome. The next time you see me and I seem like I don't want to move my arms, it's probably because I haven't been doing my exercises!


PS: During the composing of this blog posts many breaks were taken. 'Cause, of course I can't TYPE for long periods of time, either :)