Home - based physical therapy for throacic outlet syndrome

ABSTRACT

Diagnosis and treatment of thoracic outlet syndrome [TOS] are controversial. Surgical treatment has proved no excellent outcome. The results of physical therapy are variable and even disappointing. To find the results of a home-based physical therapy for improvement of TOS symptoms. Method: 65 patients who had a clinical diagnosis of TOS were studied consecutively in a one year period [1998-1999] at the Iranian Hospital-Dubai, United Arab Emirates. For the treatment, no anti-inflammatory medicine was used to find out the exact effects of the home-based physical therapy. The physical therapy and postural correction consisted of three main parts. All patients learned the exercises in the orthopaedics clinic. The results were studied based on a 10-grade pain rating scale. The mean age of the patients was 36.2 years. 33 patients were men and 32 were women. The duration of the patient's symptoms ranged from less than one month to more than one year. Right upper extremity was affected in 27.7%, left side in 44.6% and both sides in 27.7%. 47% of the patients had C7 long transverse processes on their anteroposterior neck X-rays and 2 had cervical ribs. 95.4% of the patients felt better with this treatment and 33.8% had improvement more than 50% [P<0.001]. The home-based physical therapy is objectively effective on TOS and if supplemented by anti inflammatory medicine is a suitable protocol for patients who have no easy access to physiotherapy wards. It is economical and time-saving