Why surgery for thoracic outlet syndrome?

So many people suffer in pain for weeks, months, and even years, when someone finally says, “Could it be thoracic outlet syndrome?”

What is thoracic outlet syndrome?

If you don’t know what thoracic outlet syndrome is and don’t know if you have it, you are not alone.

Most doctors don’t know what it is. Yet, according to an online search, more than 62,000 people search for the words “thoracic outlet syndrome” to determine if they have it and the best treatment for it.

Here are the facts.

Doctors who work in the field of spine care think thoracic outlet syndrome is: (1) underdiagnosed, (2) some doctors who don’t know how to examine for it say it’s overdiagnosed, (3) others say it’s misdiagnosed, or (4) they just can’t diagnose it.

Why are so many people who really have thoracic outlet syndrome misdiagnosed?

When it comes to a thoracic outlet syndrome diagnosis, the exact criteria about how to diagnose it are not well defined, even by experts.

Putting it bluntly, the majority of doctors are really confused about thoracic outlet syndrome!

Even more startling is the fact that most doctors don’t really know the cause of thoracic outlet syndrome!

Doctors can’t find the cause of a lot of different conditions.

This inability to determine the cause of a condition or disorder is not limited to sufferers of thoracic outlet syndrome.

For example, no one seems to know what causes or even what triggers fibromyalgia, but there is a drug for it. Maybe that’s why fibromyalgia statistics indicate that 10 million people suffer every day from the symptoms of fibromyalgia. With a vague cause, most have little hope of relief, except more drugs (2).

Similarly, approximately five million people have chronic fatigue syndrome symptoms. What’s the real reason so many people are so tired? Do you ever wonder why there are so many energy drinks on the market?

What is the cause of accelerated aging of the joints, such as degenerative arthritis, degenerative joint disease, or degenerative disc disease?

In the United States, more than 400,000 people have so much arthritis in their knee and hip joints that they need them replaced with artificial joints. What do you think causes the cartilage to wear out? Old age?

What about those fancy new tests? Unfortunately, many professionals use these expensive tests to find out what is “wrong” with you and that is the start and end of the diagnosis. Did you know that twice as many people got expensive MRI scans in 2006 than in 1996?

Most patients think that diagnostic tests should be able to spot a herniated disc. Once the herniated disc is discovered, is that for sure the root cause of your chronic suffering?

In 2016, I gave a presentation “The Earliest Detection, Intervention and Prevention of Compression Syndromes, TOS, Herniated Discs and Degenerative Joint Disease” at the World Congress on Anti-Aging and Longevity, Mexico City, Mexico.

Did I talk about the latest diagnostic tests? Yes!

Here is the science that puzzled the doctors in the audience. In three individual studies, Japanese researchers did MRI scans of volunteers who were pain-free, asymptomatic, and never had a neck, lower, or upper back injury in their life.

They were startled by what they found. More than 30 percent of these asymptomatic volunteers had a herniated disc and degenerative discs in their spines. Because of these studies, doctors now know they have a greater than 30 percent chance of finding a herniated disc in your neck or lower back on an MRI, regardless if you are in pain.

If they don’t know how to evaluate what is causing the pressure on the disc, they will just stick to reiterating you have a herniated disc diagnosis. They give you painkillers and injections that don’t reduce the muscle tension that is causing the compression on the disc, and then wait until you can’t take the pain anymore and beg them to perform surgery.

You’ll understand after reading this book that if doctors tell you they can diagnose thoracic outlet syndrome or most musculoskeletal conditions with a single test, such as an MRI, they are not being truthful (4).

Again, this poor diagnosis and treatment cycle is not a problem isolated to thoracic outlet syndrome. It relates to all musculoskeletal conditions.

I have patients bring me MRI scans showing herniated discs. I never focus on the herniated discs. They look at me like I don’t care. I do care, but I have several herniated discs. Mine have healed and don’t cause me any pain. These patients haven’t yet healed their discs. That is the problem.

The secret to reversing chronic pain is to find out what is getting in the way of the healing process and remove it. Then the symptoms of a herniated disc will go away.

No doctor in the world would recommend surgery for your herniated disc, if you had no pain.

If I can take your pain away in a few days, I guarantee you won’t agree to neck surgery or lower back surgery.

What causes thoracic outlet syndrome?

Thoracic outlet syndrome is caused by compression of the outlet or tunnel where the blood vessels and nerves pass from the neck or thorax to the arm.

If you and your doctor know the cause of the compression and know how to reverse it, you can save just about 100 percent of patients from surgery and stop the pain.

When you have thoracic outlet syndrome signs, have all the positive thoracic outlet syndrome tests, and get a TOS diagnosis, then you have compression of the outlet. If you have a poorly thought-out thoracic outlet syndrome, physical therapy program that doesn’t do a good job in reducing muscle tension, you will end up with chronic thoracic outlet syndrome.

So, after enough suffering, you elect to try thoracic outlet syndrome surgery. When in doubt, cut it out, right?

This thoracic outlet syndrome surgery you elected to do, called a scalenectomy, is where the surgeon cuts out the scalene muscles, because they are in a spasm, causing a raised first rib that is compressing the blood vessels and nerves between the first rib and the clavicle. You would think there is a more logical way to stop the swollen scalene muscles from raising the rib to compress the space between the clavicle and the first rib than cutting them out.

Instead, the surgeons don’t focus on the obvious, but instead do a rib resection for thoracic outlet syndrome, which is cutting out your first rib and the muscles that attach to it. To cut out your first rib, they use something that looks like pruning shears.

Are you frustrated with the lack of progress your therapists and doctors are making in the treatment of your thoracic outlet syndrome? Are you really considering a surgery to cut the supportive muscles (scalenes) out of your neck because your therapist cant keep the muscles from spasming and lifting the first rib into the outlet? Are you serious that you would consider surgery to remove a rib from your body because your therapist cannot adjust it out of the thoracic outlet?

Come on... You cant be serious about surgery just to surgically remove stubborn muscle spasms and a rib that needs some adjustments!

If you make mistakes in your game plan to reverse this complex disorder, you could be recommended for cervical disc surgery, thoracic outlet surgery, and even carpal tunnel surgery.

For more information please read Dr Stoxen's book, Neck Pain? Back Pain? Shoulder Pain? Could It Be...Thoracic Outlet Syndrome? Its available on Amazon https://www.amazon.com/dp/B07JNJTNDW/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1540361832&sr=1-1

Go to the TOS BLOG www.thoracicoutletsyndrome.com where you can read more self help articles and watch more video tutorials on how to ease your thoracic outlet syndrome. If you need a second opinion contact me by email me at [email protected] or call Dr Stoxen at 773.735.5200

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