Author(s)

Bordoni Bruno^1,2,3*, Marelli Fabiola^2,3, Morabito Bruno^2,3,4, Sacconi Beatrice⁵

¹Foundation Don Carlo Gnocchi IRCCS, Department of Cardiology, Institute of Hospitalization and Care with Scientific Address, Milan, Italy.
²CRESO, School of Osteopathic Centre for Research and Studies, Aprile, Italy.
³CRESO, School of Osteopathic Centre for Research and Studies, Fano (Pesaro Urbino), Italy.
⁴Foundation Polyclinic University A. Gemelli University Cattolica del Sacro Cuore, Rome, Italy.
⁵Sapienza University of Rome, Radiological, Oncological and Anatomopathological Sciences, Rome, Italy.

The present article comprehensively reviews the thoracic outlet syndrome (TOS), its etiology and assessment, with reference to the usual conservative treatment and surgical therapy, highlighting new definitions and reporting obsolete tests. The syndrome affects about 8% of the population, with higher prevalence in females, and rarely affects the children. Conservative, non-surgical treatment produces good results, and it becomes important to know which specific areas need to be treated. Currently, there is no rehabilitation scheme, either osteopathic or chiropractic, considered as a valid tool for a precise localization of the pathologic condition, probably due to the lack of a manual assessment process to evaluate bones and muscular components of the thoracic outlet. In this situation, the manual treatment performed is usually generic. The present article proposes a manual evaluation that can be used to identify the anatomical area which needs to be treated. This hypothesis of assessment should be carried out after the clinician has ruled out the necessity of surgery with instrumental examinations.

Thoracic Outlet Syndrome, Physiotherapy, Osteopathic, Chiropractic, Pain, Manual Evaluation, Fascia

Bruno, B. , Fabiola, M. , Bruno, M. and Beatrice, S. (2018) New Proposal of Evaluation of the Thoracic Outlet. Open Journal of Therapy and Rehabilitation, 6, 17-42. doi: 10.4236/ojtr.2018.62003.