In a recent study of 64 consecutive
whiplash cases, one researcher found the rate of TOS
symptoms to be 33%.
Another study showed that out of 491
TOS patients examined, 56% of the cases had been caused
by automobile accidents.
Damage/strain to the scalene muscles
with subsequent scarring and fibrosis of surrounding
tissues can constrict the brachial plexus as it passes
through the scalene triangle. This should be highly
considered.
Trigger points as a result of scalene
strain might cause referred paresthesias, rather than
only neurogenic origins.
Arm symptoms may not develop for days,
weeks, or even months after an injury.
Symptoms
Aching pain in the
shoulder or arm.
Heaviness or easy
fatigability of the arm.
Numbness and tingling
of the outside of the arm, and especially the 4th and 5th
fingers.
Swelling of the hand
or arm.
Finger stiffness.
Coolness and pallor of
the hand.
Treatment
Conservative treatment
including the self stretching of the scalene and pectoral
muscles should be considered first, in the absence of
severe compromise to neurovascular integrity.
Myofascial release
work can also be beneficial. This can be done by
qualified chiropractors, physical therapists, and massage
therapists.
Surgery is considered
as a last alternative only. The success rate of one study
showed that of 45 patients and 21 years after surgery,
only 43% of the operations were successful.
Other adverse affects
of TOS surgery include neurologic deficits, brachial
plexopathies, and even deaths have been reported.