The thoracic outlet syndrome diagnosis is an increasingly popular explanation for upper back and neck symptoms within the greater back pain industry. Thoracic outlet is also a relatively new diagnostic theory used to explain neurological pain and structurally-motivated ischemia in the upper back, neck, shoulders and arms. The theory usual diagnostic speculates that the scalene muscles clamp down on the nerves of the brachial plexus or sometimes even on the subclavian artery or vein, eliciting potentially terrible symptomatic expressions.
The focus of this article will detail the diagnostic process for the various manifestations of thoracic outlet pain syndrome.
Most diagnoses of thoracic outlet syndrome are theorized to exist based on a physical exam and oral patient history. This is especially true if diagnostic x-rays or MRI results do not show any positive spinal reasons to explain the symptoms. The patient will typically demonstrate chronically tight upper back and shoulder muscles, but might not provide any additional definitive evidence to support the working theory. Sometimes the diagnosis of thoracic outlet syndrome is made even if a spinal abnormality might be the source of the neurological symptoms.
The vast majority of TOS conditions are blamed on compression of one or more nerves which make up the brachial plexus. Arterial and venous forms of TOS are far less likely to be diagnosed right away and are a less common symptomatic profile, as well.
Generally, the pain is blamed on muscular interaction with the neurological structures of the brachial plexus, regardless of whether the patient has endured trauma to the region or not. If venous or arterial compression is suspected, the symptoms of ischemia will be present. Skin discoloration, tingling and numbness may be pieces of evidence used to reinforce this theory of pain.
Many misdiagnosed back pain conditions originally identified as TOS turn out to be nonstructurally-motivated oxygen deprivation syndromes instead. This means that there is a reduced blood supply, but not due to any muscular compression, as is the theory in TOS.
Unfortunately, it might take the patient many years and a wide range of unsuccessful treatments, or even a failed back surgery, to discover this fact. Even worse, many patients never learn the truth about their pain and continue to suffer for decades or even an entire lifetime.
Ischemia is rarely diagnosed; since the most common psychosomatic form clearly goes against the Cartesian philosophy embraced by most of today’s healthcare workers. This shortsighted thinking is directly responsible for the much of the back pain epidemic which is plaguing the medical system all over the world. Luckily, more and more doctors are taking notice of the research supporting nonstructural ischemia as a possible source of symptoms which have been mistakenly diagnosed as a variety of painful conditions over the years.
It is crucial to trust your doctor and abide by their advice. However, you must also take an active role in your own care by learning the facts about TOS and chronic back pain, in general. This is especially true for patients who have already been in care for a very long time without finding lasting relief from their misery. If this describes your sad situation, I implore you to get a second or third opinion on your diagnosis. Misdiagnosis is almost always where the problem resides.
If you happen to suspect nonstructural oxygen deprivation as the true source of pain rather than muscular compression, then you might want to learn more about pursuing the alternative treatment path offered by knowledge therapy. In this case, please read more of the relevant articles on this site or go to your local library to seek out additional information.