Outcome following conservative management of thoracic outlet syndrome

Conservative management of thoracic outlet syndrome is recommended as the initial treatment of choice, and yet few studies have evaluated patient outcome. This study evaluates patient subjective outcome following conservative management of thoracic outlet syndrome. Forty-two patients (37 women, 5 men), mean age 38 years, participated in a telephone questionnaire. Patients clinically diagnosed with thoracic outlet syndrome who had participated in physical therapy at least 6 months prior to the study were selected. Mean duration of symptoms before treatment was 38 months, and mean follow-up time after therapy was 1 year. Twenty-five patients reported symptomatic improvement, 10 were the same, and 7 had worse symptoms. Sixteen patients reported full work and recreational activities, and 8 patients reported restrictions in both work and recreational activities. Poor overall outcome was related to obesity (p<.04), workers' compensation (p<.04), and associated carpal or cubital tunnel syndrome (p<.04). Neck and shoulder symptoms were improved in 38 patients. Improvement in hand and arm pain was significantly better in those without concomitant distal nerve compression (p<.006).