Thoracic Outlet Syndrome (Elevated First Rib)

[sarahkelly]

Hi there,
I have just today discharged a patient with Thoracic Outlet Syndrome whose pain now at 3/10 (previously 8/10). Her first rib is elevated and her pain was relieved from caudad mobilisations (not immediately though, the next day and for about a week afterwards) I have discharged her with lots of Scalenes Stretches/Inhibitory exercises. I guess I was just wondering is what the time frame usually is, for thoracic Outlet syndrome to clear as I wasn't able to be 100% specific when I discharged her. I guess it depends on how hard she works on it. I was just wondering if anyone has had a similar case, and if so was it possible to clear the Patient's pain completely?
Thank You ,
Sarah

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[finchr]

I would recommend also giving stretches for the SCM, pec minor, and possibly Butler nerve glides for the UE. Anything that has adaptively shortened takes awhile to remodel.
My question is always why did this occur? Obviously no one wakes up1 morning and out of the blue develops a syndrome. Are there shoulder issues or blocked cervical movements that the person is compensating for ? If there is a mechanical issue in movement that produced this it has to be treated also. Can the peripheral Sx be produced is sitting with the affected UE resting on a table to place the nerve roots on slack. If so there are most likely other sources o neural impingement. Just thoughts to ponder.
If after a month they are abolished with regular stretching it needs more aggressive ( harder, longer) or look around the cervical spine

[toddchaney]

One of my friends had this syndrome. The pain hasn't gone completely but returns occassionaly on events like carying bag over the shoulder. As advised by his dcotor he does corner stretch and some neck stretching exercises. These exercises help in reducing pain a lot.