Neurogenic Thoracic Outlet Syndrome in Athletes — Nonsurgical Treatment Options

Warrick, Alexandra; Davis, Brian A.

doi:10.1249/jsr.0000000000000854

Cited by 12 publications

(3 citation statements)

References 48 publications

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“…A number of studies compare warfarin with oral anticoagulants at the lower-limb level [103], but a comparable analysis of fibrinolysis versus anticoagulation has not been evaluated in TOS. That said, beyond Paget-Schroetter Syndrome, although many authors still consider surgery the gold standard [104], despite the risks associated with surgery [105,106], nonsurgical treatment options (physical therapy, botulinum toxin injection, ultrasound-guided hydrodissection) have been proven to be effective in treating TOS [82,83,107] and are of interest in reducing the period following surgery during which sporting activities are discouraged.…”

Section: Influence Of Lifestyle On the Invasive Treatment Options For...mentioning

confidence: 99%

Role of Lifestyle in Thoracic Outlet Syndrome: A Narrative Review

Abraham,

Lecoq,

Mechenin

et al. 2024

JCM

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Introduction: The presence of a positional compression of the neurovascular bundle in the outlet between the thorax and the upper limb during arm movements (mainly abduction) is common but remains asymptomatic in most adults. Nevertheless, a certain number of subjects with thoracic outlet positional compression will develop incapacitating symptoms or clinical complications as a result of this condition. Symptomatic forms of positional neurovascular bundle compression are referred to as “thoracic outlet syndrome” (TOS). Materials and methods: This paper aims to review the literature and discuss the interactions between aspects of patients’ lifestyles in TOS. The manuscript will be organized to report (1) the historical importance of lifestyle evolution on TOS; (2) the evaluation of lifestyle in the clinical routine of TOS-suspected patients, with a description of both the methods for lifestyle evaluation in the clinical routine and the role of lifestyle in the occurrence and characteristics of TOS; and (3) the influence of lifestyle on the treatment options of TOS, with a description of both the treatment of TOS through lifestyle changes and the influence of lifestyle on the invasive treatment options of TOS. Results: We report that in patients with TOS, lifestyle (1) is closely related to anatomical changes with human evolution; (2) is poorly evaluated by questionnaires and is one of the factors that may induce symptoms; (3) influences the sex ratio in symptomatic athletes and likely explains why so many people with positional compression remain asymptomatic; and (4) can sometimes be modified to improve symptoms and potentially alter the range of interventional treatment options available. Conclusions: Detailed descriptions of the lifestyles of patients with suspected TOS should be carefully analysed and reported.

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Section: Influence Of Lifestyle On the Invasive Treatment Options For...mentioning

confidence: 99%

Role of Lifestyle in Thoracic Outlet Syndrome: A Narrative Review

Abraham,

Lecoq,

Mechenin

et al. 2024

JCM

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“…Furthermore, conservative measures seem to be the best treatment option for patients with lower positions and hypermobility of the shoulder joint [93]. Warrick et al, in their study, found that surgical and non-surgical treatment had positive results in the treatment of nTOS in athletes who perform repetitive overhead movements [135]. Beteck et al compared the results of nTOS treatment between athletes and nonathletes.…”

Section: Risk Factors and Treatmentmentioning

confidence: 99%

Congenital, Acquired, and Trauma-Related Risk Factors for Thoracic Outlet Syndrome—Review of the Literature

Maślanka,

Zielinska,

Karauda

et al. 2023

JCM

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Thoracic outlet syndrome is a group of disorders that affect the upper extremity and neck, resulting in compression of the neurovascular bundle that exits the thoracic outlet. Depending on the type of compressed structure, the arterial, venous, and neurogenic forms of TOS are distinguished. In some populations, e.g., in certain groups of athletes, some sources report incidence rates as high as about 80 cases per 1000 people, while in the general population, it is equal to 2–4 per 1000. Although the pathogenesis of this condition appears relatively simple, there are a very large number of overlapping risk factors that drive such a high incidence in certain risk groups. Undoubtedly, a thorough knowledge of them and their etiology is essential to estimate the risk of TOS or make a quick and accurate diagnosis.

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“…Enquanto, se desconfiar de SDT nervosa é importante um bom exame neurológico clínico, com avaliação da função motora, sensorial e autonômica, com reconhecimento de sinais de fraqueza muscular (Dengler et al, 2022). Além disso, atletas que se exercitam de forma repetitiva e com uso de carga são mais propensos a adquirir a síndrome neurogênica (Warrick et al, 2021). A ressonância magnética é válida para identificação de causas relacionadas aos tecidos moles e a maioria dos pacientes com SDT são submetidos a vários exames de imagem para conclusão do diagnóstico (Huang et al, 2021).…”

Section: Compartimentounclassified

Aspectos anatomoclínicos da Síndrome do desfiladeiro torácico - uma revisão narrativa

Marciano

Bezerra

Soares

2023

RSD

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Introdução: A síndrome do desfiladeiro torácico (SDT) foi descrita no século XIX como um complexo de sintomas ocasionados pela compressão de estruturas pertencentes ao desfiladeiro torácico. Por ser uma patologia pouco conhecida e ter quadro sintomatológico diverso, atualmente há dificuldades em seu diagnóstico sendo subnotificado ou mesmo indescoberto pela equipe médica. Objetivo: O objetivo do presente estudo é realizar um levantamento de dados relacionados aos aspectos anatomoclínicos da síndrome do desfiladeiro torácico, destacando a importância do conhecimento desta doença no curso médico. Metodologia: Trata-se de uma revisão bibliográfica narrativa, pesquisada na base de dados PubMed. Foram 17 artigos selecionados para o estudo, escritos em inglês, no período de 2019 a 2023, cuja temática principal fosse circunscrita aos descritores. Resultados: A SDT pode ocorrer em três regiões distintas: o triângulo escaleno, o espaço costoclavicular e o espaço peitoral, sendo essas localidades capazes de ocasionar a compressão do feixe neurovascular. Os sintomas associados são os mais diversos possíveis e dependentes das estruturas acometidas nesse cenário, como a limitação do movimento, dor ao movimento, formigamento e choques nos membros superiores. O processo diagnóstico necessita de atenção à história do paciente e exame físico detalhado, seguido de exames de imagem e testes para confirmação. No tratamento, é necessária uma equipe multidisciplinar e uma terapêutica vasta por conta da apresentação clínica multifatorial. Conclusão: Acerca do exposto, o diagnóstico diferencial é importante, para definir a terapêutica precisa e definitiva, para fins de torná-los mais presentes no labor médico, haja vista que o diagnóstico precoce favorece o cuidado efetivo ao paciente acometido.

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Neurogenic Thoracic Outlet Syndrome in Athletes — Nonsurgical Treatment Options

Cited by 12 publications

References 48 publications

Role of Lifestyle in Thoracic Outlet Syndrome: A Narrative Review

Role of Lifestyle in Thoracic Outlet Syndrome: A Narrative Review

Congenital, Acquired, and Trauma-Related Risk Factors for Thoracic Outlet Syndrome—Review of the Literature

Aspectos anatomoclínicos da Síndrome do desfiladeiro torácico - uma revisão narrativa

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