[Conservative therapy in thoracic outlet syndrome. Literature review and pathogenetic considerations]

Due to the broad clinical presentation and the lack of generally accepted diagnostic criteria, thoracic outlet syndrome (TOS) is a disputed diagnosis. Various surgical techniques have been described and investigated as treatment for TOS, whereas only a few studies have reported the outcome after a conservative approach. Based on the literature, the pathophysiology of TOS and the impact of conservative therapy are discussed. Our personal experience has shown that after early diagnosis and implementation this treatment is a safe and valuable therapeutical option in TOS based on the correction of a postural and functional disturbance of the upper thoracic aperture underlying the pathogenic process. Successful conservative treatment may also be considered as further diagnostic evidence for TOS.