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Final Program


Final Program

708 - Successful treatment of Thoracic Outlet Syndrome with Osteopathic Manipulative Treatment

Friday, February 28, 2025
5:00 PM - 6:30 PM MST

    Presenting Author(s)

  • SA

    Siam S. Ayon, DO, MS

    Resident Physician
    New York Presbyterian Queens Hospital
    Hollis, New York, United States

    • Co-Author(s)

  • AL

    Abraham E. Libman, MA

    OMS-II
    Touro College of Osteopathic Medicine
    New York, New York, United States

Case Diagnosis: Thoracic Outlet Syndrome

Case Description: A 27-year-old medical student presented to the clinic complaining of gradually progressive numbness and tingling in her right hand. The symptoms started about 2 weeks ago after she returned to the gym after a few months and was doing overhead shoulder press exercises. In physical examination, patient had significant restrictions in her Sibson’s fascia. She had positive Adson’s and Wright’s tests on her right side. There was tenderness to palpation over her right scalene muscles, pectoralis minor, and 1st rib. Given these findings, thoracic outlet syndrome (TOS) was the most likely diagnosis. The patient was treated with Sibson’s fascia release and myofascial release around her scalene and pectoralis minor muscles. Facilitated positional release was used to treat her elevated 1st rib. After three sessions of Osteopathic Manipulation Therapy (OMT), her tingling could no longer be reproduced with Adson’s maneuver.

Discussions:

TOS is often a complex condition to diagnose and treat. Often, the approach to treatment is conservative, involving the use of NSAIDs and eventual referral to physical therapy. However, as our case study suggests, OMT could be a promising first-line treatment for thoracic outlet syndrome. Some case studies show the successful management of TOS with OMT. While the role of PT is well-established in the literature, the practice of OMT is not as widespread. There is insufficient awareness among providers or patients of the role of OMT in treating TOS. We believe PT combined with OMT can produce significant relief for patients, offering a hopeful prospect for the future.

Conclusions:

Symptoms of TOS can often be debilitating for an otherwise healthy patient. We strongly recommend further study into developing a stepwise osteopathic treatment modality to treat TOS. Moreover, patient and provider education are crucial to increase awareness of the role of osteopathic physicians in treating this complex condition.