Shoulder Pain with Radiating Pain
Thoracic Outlet Syndrome can be tricky to treat because it can have both arterial and venous contributions as well as having multiple entrapment sites. Often times patients will complain of numbness or tingling in their hands as well as saying that their arms feel weak or even cold. Typically overhead movements of the upper extremities make the pain worse.
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Anatomy
Image via Complete Anatomy 2018 by 3D4 Medical
Special Test
If you suspect that your patient has thoracic outlet syndrome this test is a good place to start. If this test is positive then you can continue further testing to figure out which entrapment site is the issue. (Click image to watch 1-2 minute video)
Treatment
Once the entrapment site is found, manual therapy is a good choice to work on mobility in the area. The first rib is a common entrapment site. Take a look at how it can be mobilized! (Click image to watch 1-2 minute video)
Therapeutic Exercise
Once you have worked on the entrapment site it is important to get the nerves and vessels moving again. This can be done through nerve sliders. After the patient has mastered sliders, is not irritable, and only has pain at or near end range make sure to progress them to tensioners! (Click image to watch 1-2 minute video)