Question
I have bi-lateral vascular TOS. Sleeping is the worst time for me because I can't get comfortable. Also, swelling in my hands/fingers is bad. I wear compression garments but, is there anything else I should do besides stretching? My spine is very tight, hips are obnoxiously tight, and I literally feel twisted to the right.  Would chiropractic care help? Should I be concerned about bloodclots? I'm impinged at my subclavian vein, which also is right next to a lymph duct.  ANY help would be appreciated.

Answer
Dear Maria,

Chiropractic can help with TOS symptoms if they are being caused when compression around the vascular and neural bundle in the base of the neck or armpit area.  Often specific stretches if the scalene and pec musculature as well as lower neck adjustments and extremity adjustments to the SC joint, AC, Joint and clavicle will reduce symptoms. The issues in the pelvis/hips should be amenable to manual chiropractic care and rehab.  

However, you do need to be careful about the subclavian vein.  How are you impinged there, and what study determined this?  Is there a clot inside the vein that was found on imaging?  If so, yes this is a big concern, and you should probably not get manual adjustment techniques and only get adjusted with an instrument in that area. If the cause of the TOS is proximal subclavian stenosis (internal reduction of the size of the vessel) then chiropractic may not be able to help you, and you should seek the advise of a vascular surgeon/specialist.

The cause needs to be absolutely determined first.  If it is deemed to be musculoskeletal in origin, then I would search the local area and check out a few chiropractic offices.  Make sure that you research the doctor's qualifications and ask for a free consult.  I would also ask your family and friends for a referral to a chiropractor they trust.  Make sure that the chiropractor is made aware of the subclavian vein issue and that he/she has access to all imaging studies you have had performed.  They will also need to have your previous medical records to evaluate your case so that they can determine whether or not you are a safe candidate for spinal manipulation...if manual adjustments are not indicated, instrument adjusting can be of great value in helping to reduce pain and increasing function.

Good Luck Maria.

respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net