Scalene Muscle Injections for Neurogenic Thoracic Outlet Syndrome: Case Series

Benzon, Honorio T.; Rodes, Meghan Elizabeth; Chekka, Kiran; Malik, Khalid; Pearce, William H.

doi:10.1111/j.1533-2500.2011.00468.x

Cited by 21 publications

(14 citation statements)

References 13 publications

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“…Imaging-guided ASM/PMM blocks have since been adopted and investigated by a number of other groups and may now be considered a mainstay in the assessment of NTOS. 2,3,5,7,9,20,22,32,33…”

Section: Discussionmentioning

confidence: 99%

Exercise-Enhanced, Ultrasound-Guided Anterior Scalene Muscle/Pectoralis Minor Muscle Blocks Can Facilitate the Diagnosis of Neurogenic Thoracic Outlet Syndrome in the High-Performance Overhead Athlete

et al. 2016

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“…Imaging-guided ASM/PMM blocks have since been adopted and investigated by a number of other groups and may now be considered a mainstay in the assessment of NTOS. 2,3,5,7,9,20,22,32,33…”

Section: Discussionmentioning

confidence: 99%

Exercise-Enhanced, Ultrasound-Guided Anterior Scalene Muscle/Pectoralis Minor Muscle Blocks Can Facilitate the Diagnosis of Neurogenic Thoracic Outlet Syndrome in the High-Performance Overhead Athlete

et al. 2016

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“…Relief from less than 2 mL of local anesthesia for scalene muscle injections in patients with nTOS is not related to blockade of the brachial plexus. 11 Considering the muscle relaxation effect of botulinum toxin, the previous studies using botulinum toxin injection also supported that the effect of injection is not by blocking the nerve but by action on scalene muscles.…”

Section: Discussionmentioning

confidence: 87%

“…Whether there were symptoms of unintended brachial plexus block was as follows: 1) partial block, in cases of mild to moderate paresthesia, numbness and/or weakness (focal if involving single trunk; diffuse if multiple trunks), and 2) complete block, in cases of severe diffuse numbness and/or motor deficit of the upper extremity. 11 Also, frequencies and severities of adverse events and injection-related complications were monitored throughout the study.…”

Section: Methodsmentioning

confidence: 99%

Comparison between Steroid Injection and Stretching Exercise on the Scalene of Patients with Upper Extremity Paresthesia: Randomized Cross-Over Study

et al. 2016

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PurposeTo compare the therapeutic effects on upper extremity paresthesia of intra-muscular steroid injections into the scalene muscle with those of stretching exercise only.Materials and MethodsTwenty patients with upper extremity paresthesia who met the criteria were recruited to participate in this single-blind, crossover study. Fourteen of 20 patients were female. The average age was 45.0±10.5 years and duration of symptom was 12.2±8.7 months. Each participant completed one injection and daily exercise program for 2 weeks. After randomization, half of all patients received ultrasound-guided injection of scalene muscles before exercise, while the other was invested for the other patients.ResultsAfter two weeks, there was a significant decrease of the visual analog scale score of treatment effect compared with baseline in both groups (6.90 to 2.85 after injection and 5.65 to 4.05 after stretching exercise, p<0.01). However, injection resulted in greater improvements than stretching exercise (p<0.01). The number of patients with successful treatment, defined as >50% reduction in post-treatment visual analog scale, was 18 of 20 (90.0%) after injection, compared to 5 of 20 (25.0%) after stretching exercise. There were no cases of unintended brachial plexus block after injection.ConclusionUltrasound-guided steroid injection or stretching exercise of scalene muscles led to reduced upper extremity paresthesia in patients who present with localized tenderness in the scalene muscle without electrodiagnostic test abnormalities, although injection treatment resulted in more improvements. The results suggest that symptoms relief might result from injection into the muscle alone not related to blockade of the brachial plexus.

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“…Isolated or repeated trauma from whiplash-induced injuries to repetitive motion stress as a result of work or sports activities is a factor in up to two thirds of neurogenic TOS cases. 56 A small percentage of TOS cases are acquired through tumor metastases, osteomyelitis, or other uncommon sources.…”

Section: Scalene Muscle Injections For Neurogenic Thoracic Outlet Synmentioning

confidence: 99%

Myofascial Injections

Rivers¹,

Benzon²,

Khan³

et al. 2014

Practical Management of Pain

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Scalene Muscle Injections for Neurogenic Thoracic Outlet Syndrome: Case Series

Abstract: The relief from scalene muscle injections in patients with neurogenic thoracic outlet syndrome is not related to blockade of the brachial plexus.

Cited by 21 publications

References 13 publications

Exercise-Enhanced, Ultrasound-Guided Anterior Scalene Muscle/Pectoralis Minor Muscle Blocks Can Facilitate the Diagnosis of Neurogenic Thoracic Outlet Syndrome in the High-Performance Overhead Athlete

Exercise-Enhanced, Ultrasound-Guided Anterior Scalene Muscle/Pectoralis Minor Muscle Blocks Can Facilitate the Diagnosis of Neurogenic Thoracic Outlet Syndrome in the High-Performance Overhead Athlete

Comparison between Steroid Injection and Stretching Exercise on the Scalene of Patients with Upper Extremity Paresthesia: Randomized Cross-Over Study

Myofascial Injections

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