Thoracic Syndrome Confused Carpal Tunnel Numbness Sioux City
Thoracic Outlet Syndrome
Thoracic Outlet Syndrome (TOS) is a condition where pain in the shoulder or neck produces numbness, pain, and tingling in the hand. People often come into the office thinking that they have carpal tunnel when they actually have thoracic outlet syndrome. One way to tell the difference between the two conditions is to determine where exactly the pain is in the hand; carpal tunnel syndrome only affects the thumb, index, and middle fingers, whereas TOS affects the entire hand. The following video explains more about thoracic outlet syndrome and how it differs from carpal tunnel.
Carpal tunnel is a result of compression of the median nerve at the wrist or elbow. The median nerve runs down the arm, cuts underneath a muscle around the elbow, travels down the forearm, under the flexor retinaculum at the wrist, bringing feeling to the thumb and next two fingers. Any compression of the nerve can produce numbness, pain, weakness, or tingling in the thumb and next two fingers. Carpal tunnel symptoms do not involve the little or ring finger. Numbness, weakness, and tingling in these fingers are often the result of cubital tunnel syndrome.
In contrast, thoracic outlet syndrome is the result of decreased blood flow to the hand. The artery that runs from the neck down to the hand can be compressed in several locations, resulting in decreased blood flow to all the fingers. Two common artery compression sites are in the scalene and pectoralis minor muscles.
The reduced blood flow causes numbness, pain, and tingling in the entire hand. There can also be wrist pain and elbow pain associated with thoracic outlet syndrome. People with TOS commonly describe waking up in the middle of the night with their hands “asleep.” the symptoms worsen with continuous activity that involves the chest and shoulder muscles.
Treatment will include various physical therapy stretches, chiropractic techniques, and massage therapy to increase muscle flexibility in the shoulder and neck muscles. Massage therapy, ART, ASTYM, and Graston Technique can often be helpful therapies to enhance recovery. The therapeutic goal is to decrease compression of the artery from muscle spasms.