Cervical Traction in Conservative Management of Thoracic Outlet Syndrome

Abstract

Objective: The aim of this study was to investigate the effects of cervical traction and exercise in addition to moist heat in thoracic outlet syndrome [TOS].

Methods: Forty patients [28 males, 12 females] with the diagnosis of TOS were randomly divided into two groups. While hot pack and a standard exercise program were applied to one group [the control group], cervical traction was added to that program in the other group [the study group] for 10 sessions. The provocative physical maneuvers were applied to all patients before treatment and after three weeks of the treatment. At follow-up, every patient was questioned with a Likert scale [no cure, little, moderate, much, very much].

Results: After a rehabilitation program, improvements in Adson, hyperabduction, and hyper-extension maneuvers were statistically significant in both groups [P < 0.05]. While improvements in Roos, costoclavicular, Wright's maneuvers, and Erb tenderness were statistically significant in the study group [P < 0.05], they were not found significant in the control group [P > 0.05]. Improvement in pectoral tenderness was not statistically significant in either group [P > 0.05]. Improvement in pain was not statistically significant between the groups [90 percent versus 75 percent, P > 0.05]. Difference in numbness scores between the groups was statistically significant in favor of the study group [80 percent versus 20 percent, P < 0.001].

Conclusions: We suggest that hot pack and exercise together achieve some improvements in TOS. However, cervical traction in addition to exercise and hot pack obtains additional benefits in the conservative management of TOS.

KEYWORDS:

• Thoracic outlet syndrome
• conservative management
• cervical traction
• exercise
• moist heat