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Thoracic outlet syndrome

Thoracic outlet syndrome is a group of disorders that occur when the blood vessels or

nerves in the thoracic outlet the space between the collarbone (clavicle) and the first

rib become compressed. This can cause pain in shoulders and neck and numbness infingers.

Neurogenic TOS (caused by compression of the brachial plexus),

Vascular TOS (caused by compression of the subclavian artery or vein) and

Nonspecific or disputed TOS (in which the pain is from unexplained causes)

Occasionally, neurogenic TOS and vascular TOS co-exist in the same person.

Symptoms of TOS vary depending on the type.

Neurogenic TOS has a characteristic sign, called the Gilliatt-Sumner hand, in which

there is severe wasting in the fleshy base of the thumb. There may be numbness alongthe underside of the hand and forearm, or dull aching pain in the neck, shoulder, and

armpit.

Vascular TOS

Discoloration of your hand (bluish color)

Subclavian vein thrombosis

Arm pain and swelling, possibly due to blood clots

Throbbing lump near your collarbone

Lack of color (pallor) in one or more of your fingers or your entire hand

Tiny black spots (infarcts) on your fingers

Non-specific TOS most prominently features a dull, aching pain in the neck, shoulder,

and armpit that gets worse with activity. Non-specific TOS is frequently triggered by a

traumatic event such as a car accident or a work related injury. It also occurs in athletes,including weight lifters, swimmers, tennis players, and baseball pitchers.

CAUSES

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In general, the cause of thoracic outlet syndrome is compression of the nerves and blood

vessels in the thoracic outlet, just under the collarbone. The cause of the compression

itself, however, can vary and can include:

Anatomical defects - Inherited defects that are present at birth (congenital) may include

a cervical rib an extra rib located above the first rib or an abnormally tight fibrousband connecting the spine to the rib.

Poor posture Drooping ones own shoulders or holding head in a forward position cancause compression in the thoracic outlet area.

Trauma - A traumatic event, such as a car accident, can cause internal changes that can

compress the nerves in the thoracic outlet. The onset of symptoms related to a traumaticaccident is often delayed.

Repetitive activity - Doing the same thing over and over can, over time, wear on ones

body's tissue. Symptoms of thoracic outlet syndrome can be seen in job that requiresrepetition of movements continuously, such as typing on a computer for extended

periods, working on an assembly line, or stocking shelves and repeatedly lifting thingsabove your head. Athletes, such as baseball pitchers and swimmers, also can develop

thoracic outlet syndrome from years of repetitive movements.

Pressure on your joints - Obesity can put an undue amount of stress on the joints.

Pregnancy - Because joints loosen during pregnancy, signs of thoracic outlet syndrome

may first appear during pregnancy.

Ayurvedic view

Treatment principles applicable to Apabahukam

Kashayam

Prasaranyadi 60 ml twice daily before food

Varunadi 60 ml twice daily before food

Rasna saptakam 60 ml twice daily before food

Rasna shuntyadi 60 ml twice daily before food (Sahasra Yogam)

Prasarnyadi kshira kashayam 60 ml in the evening

Lashuna ksheera kashayam 60 ml in the evening

Tailam (Internal)

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Karpasasthyadi avarthi 1 teaspoon with milk at night after food

Ksheerabala 1 teaspoon with milk at night after food

Prasaranyadi 1 teaspoon with milk at night after food

External therapies

Podikizhi

Kolakulathadi

Lepam

Kottumchukkadi choornam

Rasnadi choornam

Abhyangam

Karpasasthyadi tailam

Prasarinyadi tailam

Parinataksheeradi

Panchasneham

Kayatrimeni

Karpaskizhi

Dhanyamladhara

Patra potali svedam

Pichu

Kottumchukkadi

Prabanjanam

Karpasasthyadi Kayatrimeni

Karpooradi

Pizhichal

Karpasasthyadi

Prabanjanam

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Parinataksheeradi

Panchasneham

Nasyam

Marsha nasyam with

Karpasasthyadi tailam

Ksheerabala tailam

Rasayanam

Lashuna rasayanam (Ashtanga Sangraha)

Tippili rasayanam

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