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Although many injuries characterized as neck strains may subside without noticeable residuals, it is possible for more severe neurological symptoms to manifest long after the initial injury occurred. Following an accident, symptoms of other trauma induced conditions may be triggered immediately or may take months (even years in some cases) to develop. One such condition is Thoracic outlet syndrome (TOS).

Thoracic outlet syndrome is a condition in which the nerves or vessels behind the collar bone become compressed or stretched. The common underlying cause of the thoracic outlet syndrome is compression of the nerves and arteries of the arm in the Thoracic Outlet. Onset of Thoracic outlet syndrome is often associated with trauma to the shoulder or neck (whiplash), such as in an automobile accident.

Symptoms of thoracic outlet syndrome include pain, numbness and tingling, swelling and coldness or weakness and fatigue in the arm and hand. Patients often experience nocturnal paresthesias, awakening with numbness or pain

Since there are no specific diagnostic tests for thoracic outlet syndrome, the diagnosis is generally made by ruling out other diseases. Physicians frequently disagree as to whether a diagnosis of Thoracic outlet syndrome is appropriate. Simply put, diagnosing this syndrome is very difficult. It is very often confused with brachial plexus syndrome, carpal tunnel syndrome, rotator cuff syndrome, a herniated disk in the neck or bursitis.

Treatment of thoracic outlet syndrome focuses on relief of the symptoms caused by compression of the nerves and blood vessels. Most physicians recommend physical therapy as the preferred method of treatment. Postural training, muscle strengthening exercises, and heat treatments with ultrasound have also proven useful as part of the physical therapy treatment component. Drugs may be used to control pain and muscle spasms. Most patients will improve with conservative treatment although some patients may require surgical intervention.

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