Author: Imke Grosse-Wilde
Supervisor: Dr. Moritz Hertel
Introduction: The thoracic outlet syndrome (TOS) manifests itself in a collection of diverse symptoms, which occur in the thoracic outlet region. TOS is caused by different compression conditions. It is a multifaceted syndrome, varying form mild to severe symptoms. It is this variance which makes it a difficult condition to manage. Diagnosis of TOS is a difficult process, chiefly because a golden standard is lacking. Therefore comparability is missing and good or excellent treatment conditions also.
Goal of the study: The aim of this systematic review was to examine the effectiveness of the various treatments available for patients with TOS. The review looked at effectiveness in terms of pain relief or paresthesia relief. The review focussed on the effectiveness of current osteopathic treatments.
Methods: Five primary studies concerning the effectiveness of treatment for patients with TOS, were evaluated. These studies were compared in terms of pain relief or paresthesia relief. The quality of these studies were also evaluated in order to assess the risk of bias on the result.
Results: The distribution of symptoms in the enclosed studies varied greaty, and were accocrdingly graded as either an early or mild of the disease, or a severe form of the disease. One study showed that patients who underwent surgical treatment for TOS gained a significant improvement in terms of pain relief and paresthesia reduction. The remaining four studies did not support the effectiveness of conservative treatments for achieving either, pain relief or, paresthesia reduction. Further research is necessary, and should focus on producing a systematic diagnosis, a standard classification (despite variances on the clinical presentation) and a uniformed assessment of the compressing structure. The advantages of surgical interventions are the focus on the structure and their mechanical relief.