Treatment of Neurogenic Thoracic Outlet Syndrome with Brachial Plexus Compression
Clinical Scenario
This protocol addresses neurogenic thoracic outlet syndrome (NTOS) — a condition defined by symptoms and signs caused by compression and irritation of the brachial plexus at the scalene triangle or pectoralis minor space. Diagnosis requires the presence of qualifying clinical criteria consistent with NTOS.
Condition
Patients present with symptoms attributable to brachial plexus compression and irritation. Establishing the NTOS diagnosis relies on a defined set of clinical criteria, of which at least three of four must be present.
Treatment Approach (Overview)
Initial management is nonoperative and may involve a combination of ergonomic modifications, physical therapy, and pharmacological or injection-based interventions. The full structured regimen — including the specific sequence, choice of interventions, and further details — is available in the complete protocol.
References
DOI: 10.1016/j.jvs.2016.04.039
- Patients have symptoms caused by compression and irritation of the brachial plexus causing symptoms and signs as described in the later section.
- NTOS should be defined by the presence of three of the following four criteria.
- Ergonomic modifications at work and home or workplace
- Physical therapy
- Medications
- Therapeutic muscular, perineural, epidural, or other injections (steroids, botulinum toxin)
View source ↗