title: Thoracic outlet syndrome: a controversial clinical condition. Part 2: non-surgical and surgical management.
abstract: BACKGROUND
  Proper management of thoracic outlet syndrome (TOS) requires an understanding of the underlying causes of the disorder. A comprehensive examination process, as described in Part 1 of this review, can reveal the bony and soft tissue abnormalities and mechanical dysfunctions contributing to an individual's TOS symptoms.
  
  
  OBJECTIVE
  Part 2 of this review focuses on management of TOS.
  
  
  CONCLUSIONS
  The clinician uses clinical examination results to design a rehabilitation program that focuses on correcting specific problems that were previously identified. Disputed neurogenic TOS is best managed with a trial of conservative therapy before surgical treatment options are considered. Cases that are resistant to conservative treatment may require surgical intervention. True neurogenic TOS may require surgical intervention to relieve compression of the neural structures in the thoracic outlet. Surgical management is required for cases of vascular TOS because of the potentially serious complications that may arise from venous or arterial compromise. Post-operative rehabilitation is recommended after surgical decompression to address factors that could lead to a reoccurrence of the patient's symptoms.
authors: Center for Rehabilitation Research, School of Allied Health Sciences, Texas Tech University Health Science Center, USA.
authors: Troy L
authors: TL
authors: Hooper
authors: Jeff
authors: J
authors: Denton
authors: Michael K
authors: MK
authors: McGalliard
authors: Jean-Michel
authors: JM
authors: Brismée
authors: Phillip S
authors: PS
authors: Sizer