Common Symptoms of Thoracic Outlet Syndrome

A patient with thoracic outlet syndrome can experience a range of symptoms. However, symptom severity will depend on the level of compression the individual experiences. Here’s a brief list of symptoms common to patients with thoracic outlet syndrome: 

• Pain in shoulder and neck area
• Numbness and tingling in the fingers or hand
• Pale color in fingers or hand
• Weakened grip
• Limited arm mobility in extreme cases

Some patients experience compression of their nerves and blood vessels in this area after a serious car accident or work injury. Others may deal with symptoms due to an anatomical deformity or other unknown reasons. 

Types of Thoracic Outlet Syndrome Treatment

To improve the compression and relieve the pain caused by thoracic outlet syndrome, most doctors recommend physical therapy to help the body learn to heal. The best course of therapy depends on whether the compression is vascular or neurogenic — whether it’s affecting blood vessels or nerve systems. In severe cases, patients might need surgery.

If therapy is not enough to relieve the pain, patients may be prescribed pain medication to improve their quality of life. While pain relief is an important part of the process, the most vital aspect of treatment is relieving compression in vascular cases so blood clots don’t further impact health. One of the most impactful ways to treat thoracic outlet syndrome is with aqua therapy. 

How Water Can Help Thoracic Outlet Syndrome

Water therapy provides gentle support that creates an ideal situation for physical therapy exercises. When a patient moves in the water, their muscles and joints are naturally buoyed up. Their movements are slow and supported, as the water offers extra resistance with less risk of injury. Completing exercises in the water can help the body heal faster and give patients confidence to pursue recovery goals without fear of further physical damage. 

One HydroWorx patient, Lori Durenleau, was suffering from the impact of extreme thoracic outlet syndrome. Through hydrotherapy intervention, she saw significant improvements to her symptoms and mobility. Despite her pain, Lori was courageous and wouldn’t give up until she found help. Keep reading to learn more about Lori’s amazing story:

The Accident

Lori Durenleau worked as an industrial sales representative until one day a 62 pound box of nuts and bolts fell, impacting her head, shoulder and leg. This injury triggered a life-long battle with Thoracic Outlet Syndrome (TOS). Thoracic outlet syndrome is a result of the compression of nerves and/or blood vessels between the base of the neck and the armpit.

Treatment for TOS can include physical therapy, adjusting one’s stance and shoulder positioning, pain reducers, and in severe cases, surgery. The accident also caused long thoracic nerve palsy resulting in winging of the scapula as well as Phrenic nerve damage.

A long thoracic nerve injury can cause paralysis, pain, weakness, limitation of shoulder elevation and can be completely disabling. Lori woke up from her thoracic surgery unable to move her arm. Lori also experienced winging of the scapula, which meant that not only was Lori unable to move her arm of her own accord, but also that her scapula protruded at an awkward angle from her body. For the next two years, her dominant right arm hung lifeless at her side.

The phrenic nerve is responsible for the control of the diaphragm, the primary muscle involved in breathing. The damage to this nerve has caused a continued need for Lori to build and maintain the strength of her diaphragm muscle in order to maintain her respiratory function.

Lori’s Recovery

Lori searched relentlessly for answers to beat the odds in her recovery. In her search, she came across the aquatic therapy program at The Hetrick Center in Middletown, PA.

Aquatic therapy has been a blessing for Lori. Today, she has regained almost all arm and shoulder function. Her aquatic therapy keeps both her arm and respiratory system functioning well. Although she has been coming to The Hetrick Center for 15 years, the improvements are still obvious.

Over the years, Lori has tried to use only land therapy. However, she’s noticed that her medication intake increases and her scapular swinging returns when aquatic therapy is eliminated from her therapies. So today, Scott Colman works tirelessly with Lori in the HydroWorx 2000 Series pool to create new, creative and innovative exercises to continue to advance Lori. Even after all these years, the possibilities are endless, because as Dr. Colman points out, water allows you to be creative.

Here is what an average aquatic therapy session might entail for Lori today:

• Running
• Shoulder Abduction and Extension
• Bicycles
• Dumbbell Curl/Press
• Narrow Dumbbell Fly
• Abduction/Adduction
• Lateral Dumbbell Raises
• Shoulder Press and Core Stabilization

Watch videos of her case history and her pool session below:

A Second Case Study: Carolyn

For one back pain sufferer, Carolyn, the pain was so severe at one point she actually felt that dying would have been a better alternative. Thanks to aquatic therapy at Geisinger Healthsouth with physical therapist, Tammy Frey, she no longer feels that way and is much more mobile! When Carolyn began her rehabilitation in the HydroWorx 2000, she could barely walk at .5mph and her range of motion was very limited.  After a few months she was up to 2.2 mph, back to full range of motion and pain-free.

The warm 93-degree water of the pool makes it much easier for her to get moving.  Stretching and strengthening exercises are important for her to loosen her tight hip flexors and muscles. Many of these exercises are used to strengthen her core and back safely. After a great workout, including walking at a speed she can’t believe, therapy jets are used to relieve and massage any aching or tired back muscles.

Watch the full back pain aquatic therapy case study here:

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