Occupational therapy treatment for NTOS

Abstract

When treating patients with neurogenic thoracic outlet syndrome (NTOS), the focus of occupational therapy (OT) is to decrease the impact of symptoms on daily activities, teach proper body mechanics and/or compensatory positioning, and prevent symptoms from further impacting the patient's life. OT can be used as the primary treatment for NTOS or as a part of the postoperative recovery process in patients who have undergone thoracic outlet decompression. A key to the alleviation of symptoms and an increase in recovery speed is teaching surgical and non-surgical patients to maintain appropriate posture while performing everyday activities. Providing the patient with information and skills needed regarding the positions that will close off the outlet and potentially increase symptoms and pain will aid the patient in independence in symptom management. Specific maneuvers include the avoidance of compression at the shoulder, side-lying sleep position, and the avoidance of prolonged or repetitive overhead arm use.