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what can i do about thoracic outlet syndrome?

19/3/2024

 
By Duke Autret, Myotherapist

If your doctor has diagnosed you with Thoracic Outlet Syndrome (TOS), you may be wondering what to do next to treat the pain, numbness or tingling in your neck, shoulder or arm.

​Lets first look at what this condition is, in easy to understand terms. We'll also look at another condition called Scapulocostal Syndrome that shares similar symptoms.  Then we will look at the ways a Myotherapist can help you with the neck, shoulder, arm or hand symptoms you're experiencing, whether its from Thoracic Outlet Syndrome or Scapulocostal Syndrome.
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What is TOS?
Thoracic Outlet Syndrome is a condition characterised by compression of the nerves and blood vessels in the thoracic outlet area, located between the collarbone and the first rib. This compression can lead to a variety of symptoms, including pain, numbness, and tingling in the neck, shoulder, arm, and hand. 

Causes & Symptoms of Thoracic Outlet Syndrome
TOS can be caused by a combination of factors, including:
  1. Anatomical Variations: Certain anatomical features, such as a narrow thoracic outlet or an extra rib (cervical rib), can predispose individuals to TOS.
  2. Repetitive Movements: Activities that involve repetitive movements of the arms or shoulders, such as typing or carrying heavy loads, can contribute to muscle imbalances and compression of the thoracic outlet structures.
  3. Trauma or Injury: Accidents or injuries, such as whiplash injuries or fractures of the collarbone or ribs, can also lead to TOS.

Common symptoms of TOS include:
  • Pain, numbness, or tingling in the neck, shoulder, arm, or hand
  • Weakness (or even muscle wasting) in the affected arm
  • Coldness or changes in skin temperature in the affected arm
  • Swelling or discolouration of the arm

Scapulocostal Syndrome is a Related Condition
Scapulocostal Syndrome, also known as snapping scapula syndrome, shares similarities with TOS. It involves excess tension, trigger points, irritation or inflammation of the soft tissues between the scapula (shoulder blade) and the ribs, resulting in pain behind the shoulder blade and upper back with sometimes audible or palpable snapping or clicking sensations during shoulder movement.

Commonalities Between TOS and Scapulocostal Syndrome
  1. Muscle Imbalances: Both conditions can result from muscle imbalances or poor posture, leading to compression of nerves and blood vessels in the thoracic outlet or between the scapula and ribs.
  2. Repetitive Movements: Activities that involve repetitive shoulder movements or overhead activities can exacerbate symptoms in both TOS and scapulocostal syndrome.
  3. Symptoms: Similar symptoms may occur in both conditions, including pain, numbness, tingling, and weakness in the affected arm, shoulder blade or shoulder region.

Myotherapy Interventions for TOS and Scapulocostal Syndrome:
Targeted Manual Techniques
  1. Soft Tissue Manipulation: Myotherapists utilise soft tissue manipulation techniques to release tension and alleviate compression of the brachial plexus (nerve bundle) in the thoracic outlet or between the scapula and ribs.
  2. Trigger Point Therapy: Targeted pressure on specific muscle points helps relieve pain and improve range of motion of the muscles and joints in the affected areas.
Postural Correction and Strengthening Exercises
  1. Postural Awareness: Myotherapists educate individuals on proper posture and ergonomic principles to reduce strain on the thoracic outlet or scapulocostal region.
  2. Strengthening Exercises: Tailored exercises strengthen the muscles surrounding the thoracic outlet or scapulocostal area, improving stability and reducing compression.
  3. Nerve Glides: These are exercises to help the nerves lengthen and/or slide freely throughout their pathways and relieve compression induced symptoms. 


Thoracic Outlet Syndrome and Scapulocostal Syndrome can significantly impact daily life, causing pain and discomfort in the neck, shoulder, arm, and hand. Myotherapy offers tailored interventions to address the underlying muscle imbalances, reduce compression, and alleviate symptoms associated with these conditions.

​If you're experiencing symptoms of TOS or scapulocostal syndrome or you've been given the diagnosis by your GP, consulting a qualified myotherapist is the first step towards finding relief and improving your overall well-being.
Take proactive steps towards a pain-free life today and book a time with a great Myotherapist here at Simple Wellness Myotherapy.

What is Sciatica?

15/4/2019

 
You might be familiar with that sharp, shooting pain sensation in your lower back, hip and leg. It can also be felt as numbness, pins and needles, tingling or burning type of sensations. Whatever way the pain or symptoms present, it runs along the Sciatic nerve - which is why this is referred to as Sciatica.

But did you know theres more than one potential cause behind this pain?

Often this pain can be linked to muscle tension in the glutes and hips. The Sciatic nerve runs underneath the muscles of your glutes, and when it gets compressed there it can be a real pain in the bum - literally!
Because this nerve runs all the way down to your feet, the jolts of nerve pain can sometimes be felt anywhere from just localised in your buttocks and hip, to the back of your thigh, behind the knee, straight down your lower leg and even into the base of your foot.

The Sciatic nerve can be impacted at the root of the nerve near the spine, however this doesn't always mean there will be pain. Often this is called a Bulging Disc or Herniated Disc, but you might be surprised to learn that even though "Bulging Disc" sounds pretty awful, studies have shown that more than 50% of people over 40 with no pain symptoms at all can have a disc bulge show on scans.

Irritation or compression of the Sciatic nerve can be common after serious trauma to your leg or lower back. Things like car accidents, falls, and horse riding accidents are all common high impact incidents that can aggravate the nerve. If you've had an injury like this, its wise to seek treatment for it.

Do you have Sciatic nerve pain or nerve symptoms of numbness, tingling and pins and needles? Book an appointment with us to have an assessment and treatment. If we can resolve the issue, we'll create you a treatment plan that includes manual therapies and a take home exercise program. 

More serious causes do exist, so if treatment of the muscles and joints is not relieving your pain, we'll refer you to see your GP to rule out any serious structural or pathological conditions.

Whats in a Nerve?

3/4/2019

 
We all know that our bodies are full of these things called nerves, but have you ever wondered how they work to control your body?

Lets have a look at two important types of nerves in your body - the ones that tell you sensory information like touch or taste, and the ones that move your muscles and joints.

Sensory nerves are responsible for everything you feel or sense. The five senses - sight, sound, touch, taste and smell - all fall under this category.
Any awareness you have of the feeling or sensation of your body comes from the sensory nerves.
The main sub types of these nerve receptors are mechanoreceptors, chemoreceptors and thermoreceptors.

Mechanoreceptors respond to pressure and touch. When you feel muscles stretch out, or when you're aware of the chair you're sitting on, thats all thanks to mechanoreceptors.

Chemoreceptors send information about chemical changes. This could be like the warming feeling of rubbing Deep Heat over your sore shoulder, as well as internal biochemical changes, like lactic acid build up after doing a big workout.

Thermoreceptors tell us about temperature. They respond when you touch something hot or cold, and are the reason you'll quickly pull your hand away from a hot stove to avoid a serious burn.


Then we have your Motor nerves, these are the ones that control movement.
Every time you make a movement, its because these Motor nerves are sending a signal from your brain to the muscle they activate saying "Move!"
Fun fact - muscles can only ever pull, they can't push! So when you activate your biceps to bend your elbow the biceps muscle contracts and gets shorter which pulls your forearm upwards. When you want to stretch your elbow back out straight, your Motor nerves activate your triceps which then pull your forearm back down to straighten the elbow.


Everything in the body is controlled by nerve signals. The brain is like the control centre, and the nerves move out from the brain into all the tissue of your body - muscles, joints, organs, the lot.
Some nerves can be over a metre long, like the ones that send signals to and from your toes.

The nerves in your arms and hands all connect in via your neck, which is why we like to assess and treat your neck if you're having any pain, or tingling or other "nerve-y" symptoms in your hands and arms.
The same goes from the nerves for your feet and legs - they extend out through your lower back, which is why we consider your back when you come in for treatment for your foot, ankle or leg.

How can you tell if your pain or symptoms are nerve related?
If a Sensory nerve is involved in your pain it can feel like sharp, shooting pains, tingling, pins and needles, numbness, or just feeling "weird" (we call that parasthesia)
If its a Motor nerve thats involved, the muscle groups that nerve activates can be weak, or in extreme situations might not be able to activate at all.

If you think your symptoms may be nerve related, book in with your Myotherapist for a full assessment and treatment plan.

    Meet Our Team

    We have a team of great practitioners available 7 days a week at our Rowville clinic.

    Mel Simon
    Mel is our Senior Myotherapist.
    She's a nerdy, geeky bookworm who loves to help explain complex pain in an easy to understand way.
    ​She has a special interest in chronic pain conditions like fibromyalgia and Ehlers Danlos Syndrome, and more.

    Duke Autret
    Duke is an outstanding Myotherapist and Remedial Massage Therapist.
    He has a deep interest in movement and alignment. He enjoys helping people regain strength and mobility to reduce their pain.

    Kel Levi
    Kel is an experienced Myotherapist and Remedial Massage Therapist, currently also working with AFL Premiers Melbourne Football Club.
    She has a great firm pressure and expertly uses Myotherapy tools like dry needling and cupping to ease pain.

    Peter Pascalis
    Peter has over 10 years experience as a Remedial Massage Therapist, and completed his Bachelor of Health Science in Myotherapy in 2022.
    He is known as our Dry Needling Wizard, and gets exceptional results for chronic pain and acute injuries using advanced needling techniques.

    Megan Cornish
    Megan is a Myotherapist and Remedial Massage Therapist. She has a background in dancing and is a qualified personal trainer. She has personal interest in womens health issues like pregnancy care, endometriosis and PCOS.

    Rachael Bird
    Rachael is a Myotherapist and Remedial Massage Therapist, with a background in beauty therapy. She is enthusiastic about helping people recover from pain and live well.

    Ethan Farr
    Ethan is a Sports Myotherapist and Exercise Scientist. He loves to help people get back to sport, exercise and activity after injuries by planning out a comprehensive rehab plan.

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