Repetitive Microtrauma as a Cause of Thoracic Outlet Syndrome

ABSTRACT

PURPOSE: The aim of this study was to analyze the repetitive stress of neck and shoulder area as a cause of thoracic outlet syndrome which is relatively common but frequently underestimated. MATERIALS AND METHODS: We analyzed 110 patients (114 cases) diagnosed as thoracic outlet syndrome. We designed diagnostic criteria of thoracic outlet syndrome involving symptom, tenderness, Tinel's sign and provocation tests. We reviewed the clinical, radiologic records and questionnaire about repetitive job related microtrauma. The questionnaire was established to investigate the relation between work history and thoracic outlet syndrome based on Labor Standards by Ministry of Employment and Labor. RESULTS: Accumulated repetitive stress on the neck and shoulder associated with work as a presumed cause of thoracic outlet syndrome were found in 88 cases (77.2%). The most common stress related to the development of thoracic outlet syndrome was occupation that requires repetitive shoulder action (more than 2.5 times per a minute) and the most common duration they exposed to the labor per day was more than 4 hours a day. CONCLUSION: Repetitive microtrauma of neck and shoulder can be a cause of thoracic outlet syndrome. In patients with a history of work related microtrauma, accurate physical examination and clinical history are important for diagnosing thoracic outlet syndrome.