The Chiropractic Doctors' Association of Hong Kong


【Chiropractic Research】Vascular Thoracic Outlet Syndrome



Eric Chu
King Yi Leung
Lucina Lo Wah Ng
Ada Yuk Yin Lam


Thoracic Outlet Syndrome, Conservative Management


Objective: To discuss the chiropractic management of a patient with vascular thoracic outlet syndrome.


Clinical Features: A 30-year-old male reported sudden onset of intermittent numbness, tightness, and weakness in his right hand. He presented with skin flakes of his right upper limb, cyanosis in the right shoulder; and a cold and pale right hand. Exercise was identified as the provoking motion. Orthopedic examination revealed a positive Allen’s test and modified Adson’s tests. His motor strength of right elbow/wrist flexors and extensors were graded 4/5, and both flexors and abductor of his right 5th metacarpal were significantly weaker than his left. He had been previously diagnosed by a neurologist with arterial thoracic outlet syndrome and prescribed muscle relaxants, physiotherapy exercise, massage therapy, and acupuncture.


Intervention and Outcome: The treatment protocol included spinal manipulative therapy, thermal ultrasonography, instrument-aided soft-tissue mobilization, and extension-compression traction. His symptoms completely resolved, and his repeated orthopedic exams for thoracic outlet syndrome and cervical lordosis were normal.


Conclusion: A 30-year-old male with vascular thoracic outlet syndrome was successfully treated with chiropractic management.


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