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Thoracic Outlet Syndrome Causes And Therapy in Malaysia
Thoracic Outlet Syndrome or TOS is a group of conditions that involves pain, numbness, or tingling sensation in the neck or upper limb due to compression of the neurovascular structures. This condition is prevalent in athletes that are actively involved in overhead sports. People with poor postures, such as drooping shoulders, are more susceptible to thoracic outlet syndrome, reducing the thoracic outlet area.
Congenital abnormalities in the neck can compress the neurovascular structures in the thoracic outlet and result in chest pain, neck pain, upper back pain, or shoulder pain. The thoracic outlet signs and symptoms will present in the chest, collarbone area, upper back, or upper extremities. Congenital disabilities or congenital anomalies of the neck or chest are common causative factors in developing a TOS. We have provided two below:
- Cervical rib: These include complete or incomplete cervical rib with a fibrous band that forms around the transverse process of the lower cervical segments.
- Collar bone defomrity: Collar bone or clavicular abnormalities are a few congenital abnormalities that can cause neurovascular compression at the thoracic outlet.
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Cervical ribs can present just on one side but are more commonly found on both sides when present. However, not everyone with cervical ribs has signs and symptoms of thoracic outlet syndrome. Only about 10% of patients with cervical ribs have signs and symptoms of thoracic outlet syndrome. Shortening and tightening of the scalene muscles due to active trigger points can result in thoracic outlet syndrome. Patients with fractured first rib or clavicle, pseudoarthrosis of the clavicle, malunion of clavicular fractures, callus formation, or crush injury to the upper thorax are at a higher risk of developing thoracic outlet syndrome.
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