Physical therapy for NTOS

Abstract

Many, if not most patients with neurogenic thoracic outlet syndrome (NTOS) benefit from physical therapy, either as sole treatment or as an adjunct to surgery. Over the past few decades we have developed a protocol based on our perspective of the etiology and management of a variety of types of cumulative trauma disorders (including NTOS) which brings together the knowledge, experience and clinical findings to focus on the interactions of the structure and function of the human body and how it adapts to repetitive trauma whether that trauma is caused by accidents, life activities, or disease. The residual impairments and functional disabilities that result have factors in common that can be identified and corrected. Discussion of findings regarding evaluation and intervention effectiveness will be intertwined with specific clinical ideas for managing patients with these conditions. A model addressing the behavioral, biomechanical, cardiopulmonary and neurological aspects of chronic pain and repetitive strain injuries will broaden the traditional role of the orthopedic or neurological physical therapist. Further, this model will help to shift the traditional role of the physical therapist from a "hands on provider" to an educator/coach whose role is to empower the patient to take responsibility for improving quality of life.