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Related Experiment Video

Updated: Jun 14, 2025

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Transaxillary First Rib Resection for Treatment of the Thoracic Outlet Syndrome

Published on: September 13, 2020

Upper Vascular Thoracic Outlet Syndrome: A Case Study.

Agnieszka Wierciak-Rokowska¹, Agnieszka Sliwka², Mikolaj Maga³

¹Independent Researcher, Reha Centrum, Physiotherapy Practice, Orthopaedic Field, Zakopianska Street 166, 30-435 Krakow, Poland.

|August 29, 2024

Summary

Thoracic outlet syndrome (TOS) is a rare vascular condition. This study presents a physiotherapy protocol for venous TOS (VTOS) that significantly improved symptoms and function in a patient.

Keywords:

TOS nonoperative management physiotherapy in TOS upper thoracic outlet syndrome vascular TOS

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Area of Science:

Vascular Surgery
Neurology
Physical Therapy

Background:

Thoracic outlet syndrome (TOS) affects about 8% of the population, with vascular presentations being rare and difficult to diagnose.
Established rehabilitation protocols for upper extremity venous TOS (VTOS) are lacking due to its infrequent occurrence.

Observation:

A case study of a middle-aged woman with right-sided venous TOS presenting with pain, edema, and discoloration in the right upper extremity.
The patient underwent a specific clinical examination and physiotherapy treatment protocol.

Findings:

After 10 physiotherapy sessions, the patient experienced a ~40% reduction in symptoms, ~15% improvement in sports performance, and ~25% improvement in work capacity.
Significant improvements were noted in TOS provocation tests, including 50-100% improvement in pulse rate and 30% reduction in extremity discoloration.
Marked improvement in upper quadrant posture was observed, indicating positive functional and aesthetic changes.

Implications:

This case demonstrates the potential for significant recovery in venous TOS patients, even with chronic conditions post-thrombosis.
The presented clinical examination and physiotherapy protocol may offer a viable management strategy for VTOS.
Further research into standardized protocols for VTOS rehabilitation is warranted to improve patient outcomes.