{"id":21339,"date":"2026-04-10T17:18:32","date_gmt":"2026-04-10T17:18:32","guid":{"rendered":"https:\/\/hlsllc.org\/tos\/?page_id=21339"},"modified":"2026-04-14T14:17:29","modified_gmt":"2026-04-14T14:17:29","slug":"conservative-treatment","status":"publish","type":"page","link":"https:\/\/hlsllc.org\/tos\/conservative-treatment\/","title":{"rendered":"Conservative Treatment"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"21339\" class=\"elementor elementor-21339\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3185a01 e-con-full e-flex e-con e-parent\" data-id=\"3185a01\" data-element_type=\"container\" data-e-type=\"container\" id=\"top\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3109980 elementor-widget elementor-widget-heading\" data-id=\"3109980\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Conservative Treatment of Neurogenic <br>Thoracic Outlet Syndrome\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0f32c24 e-con-full e-flex e-con e-parent\" data-id=\"0f32c24\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-45a5d16 e-con-full e-flex e-con e-child\" data-id=\"45a5d16\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-33b5c1e elementor-widget elementor-widget-heading\" data-id=\"33b5c1e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Conservative treatment of neurogenic thoracic outlet syndrome remains the primary treatment modality\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-f25763e elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"f25763e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9f7d67b elementor-widget elementor-widget-text-editor\" data-id=\"9f7d67b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-title title fusion-title-text fusion-title-size-paragraph\"><div class=\"fusion-text\"><div class=\"fusion-li-item-content\"><div class=\"fusion-text fusion-text-1\"><div class=\"fusion-text fusion-text-3\"><p class=\"fusion-responsive-typography-calculated\" data-fontsize=\"28\" data-lineheight=\"36.4px\">Conservative treatment remains the primary approach in almost all patients with\u00a0<a href=\"https:\/\/www.tosmri.com\/what-is-thoracic-outlet-syndrome\/types-of-thoracic-outlet-syndrome\/neurogenic-thoracic-outlet-syndrome\/\">neurogenic thoracic outlet syndrome<\/a>.\u00a0Treatment of neurogenic thoracic outlet syndrome\u00a0rarely, if ever, represents a surgical emergency. Therefore, treatment planning and trials can be much more deliberate and staged. Progress can be judged over these trials, and surgery may be avoided in many patients with\u00a0neurogenic TOS. Conservative treatment of neurogenic\u00a0<a class=\"wpil_keyword_link\" title=\"thoracic outlet syndrome\" href=\"https:\/\/www.tosmri.com\/what-is-thoracic-outlet-syndrome\/thoracic-outlet-syndrome\/\" data-wpil-keyword-link=\"linked\" data-wpil-monitor-id=\"49\">thoracic outlet syndrome<\/a>\u00a0modalities may be performed sequentially or in conjunction with one another. Although the medical literature does not prove superiority of one form of conservative therapy over another, authorities widely accept conservative treatment of neurogenic thoracic outlet syndrome\u00a0as the first step in\u00a0<a href=\"https:\/\/www.tosmri.com\/treatment-of-thoracic-outlet-syndrome\/treatment-of-neurogenic-thoracic-outlet-syndrome\/\">treatment of neurogenic thoracic outlet syndrome<\/a>.<\/p><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-bde016c elementor-widget elementor-widget-image\" data-id=\"bde016c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"600\" height=\"400\" src=\"https:\/\/hlsllc.org\/tos\/wp-content\/uploads\/2026\/04\/Female-Patient-Asian-Conservative-Treatment-Stretch-Band-Cropped-2.jpeg\" class=\"attachment-large size-large wp-image-21348\" alt=\"\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5ffd092 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"5ffd092\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-417a2dd elementor-widget elementor-widget-heading\" data-id=\"417a2dd\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Physical Therapy\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-10035a9 elementor-widget elementor-widget-text-editor\" data-id=\"10035a9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-title title fusion-title-text fusion-title-size-paragraph\"><div class=\"fusion-text\"><div class=\"fusion-li-item-content\"><div class=\"fusion-text fusion-text-3\"><div class=\"fusion-text fusion-text-10\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-7 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\"><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-7\"><div class=\"fusion-text fusion-text-8\"><p>Physical therapy remains one of the mainstays of conservative treatment of patients with\u00a0<a href=\"https:\/\/www.tosmri.com\/why-do-you-need-an-imaging-test-for-tos-unveiling-neurogenic-tos-diagnosis\/\" data-wpil-monitor-id=\"17\">neurogenic TOS<\/a>. Physical therapy aims to reduce pain and improve function. Physical therapists help their patients recover from sports injuries, trauma, or strokes, improve flexibility or movement, and learn to use a cane or function with a splint.<\/p><p><a href=\"https:\/\/my.clevelandclinic.org\/health\/articles\/24625-physical-therapist\" target=\"_blank\" rel=\"noopener\">Physical therapists<\/a>\u00a0must undergo specific training, including a masters degree or a doctorate. They also must pass a qualifying examination, and are licensed in every state. It is\u00a0important to remember that just like physicians, physical therapists often specialize within their field. Thus, a patient should strive to work with a physical therapist who is knowledgeable about and experience in the treatment of neurogenic TOS.<\/p><p>Physical therapists who treat patients with\u00a0neurogenic TOS may use one or more of the following techniques:<\/p><ul><li>Massage therapy<\/li><li>Postural correction<\/li><li>Breathing control and retraining<\/li><li>Electrical stimulation<\/li><li>Stretching<\/li><li>Superficial heat or deep heat therapy (ultrasound may be used)<\/li><li>Myofascial release, including mobilization and manipulation<\/li><li>Education<\/li><\/ul><p>The ENVEST (Edgelow Neurovascular Entrapment Syndrome Treatment)\u00a0technique was developed by a widely-recognized physical therapist, Peter Edgelow. The ENVEST technique is widely known as a specialized and effective technique for treatment of\u00a0neurogenic TOS patients. Dr. Edgelow taught his technique to many hundreds of physical therapists, and it is worth finding a therapist who is familiar and experienced with this technique. You can read more the ENVEST technique here.<\/p><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-33b3f70 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"33b3f70\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-880eace elementor-widget elementor-widget-heading\" data-id=\"880eace\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Chiropractic<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9b5e4f1 elementor-widget elementor-widget-text-editor\" data-id=\"9b5e4f1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Chiropractic focuses on the relationship between the structure and function of the body. Primarily, chiropractors manipulate the spine to achieve balance, with the intention of maintaining or restoring balance and normal function. However,\u00a0<a href=\"https:\/\/www.tosmri.com\/diagnosis-of-thoracic-outlet-syndrome\/find-a-thoracic-outlet-syndrome-specialist\/\">chiropractors<\/a>\u00a0often add a number of other therapies to spinal manipulation. For example, many chiropractors offer electrical stimulation, relaxation techniques, laser therapy, and counseling on diet, exercise and health.<\/p><p>Many patients with\u00a0neurogenic TOS utilize chiropractic as a central and critical component of their treatment program. Chiropractors contribute significant hands-on therapy and time with patients. Patients often form a productive therapeutic alliance with their chiropractor, among other team members.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-80bdaed elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"80bdaed\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8e7321b elementor-widget elementor-widget-heading\" data-id=\"8e7321b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Drugs<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1c64799 elementor-widget elementor-widget-text-editor\" data-id=\"1c64799\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Appropriate use of drugs plays a key role in the conservative treatment of patients with\u00a0neurogenic TOS. Several classes of drugs may be used:<\/p><p>Pain drugs-Direct treatment with pain medication is almost always a part of the regimen. Pain medications may include NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen, or stronger opiates such as fentanyl in severe flares. In general, opiate pain medications have significant risks, including addiction, and are only used in a short-term plan or flare.<\/p><p>Nerve-stabilizing drugs-These drugs were originally developed to treat depression or seizures. However, they have been found to help desensitize irritated nerves and to reduce the pain signals created by these nerves. Examples include anti-depressants, such as Elavil, and anti-seizure drugs such as Lyrica, Cymbalta, and Neurontin.<\/p><p>Evidence has also recently been published regarding the use of medical marijuana in chronic pain patients. Marijuana has been shown to work effectively with opiates, decreasing the dose of opiates required while lowering pain to a greater extent than opiates alone.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7ecd0be elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"7ecd0be\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b1d44bf elementor-widget elementor-widget-heading\" data-id=\"b1d44bf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Occupational Therapy\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1b04a0c elementor-widget elementor-widget-text-editor\" data-id=\"1b04a0c\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-4 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling fusion-equal-height-columns\"><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-5 fusion_builder_column_2_3 2_3 fusion-two-third fusion-column-first\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-10 nitro-offscreen\"><p>Occupational therapists help patients perform activities regardless of disability or injury. Stated another way, occupational therapists do not aim to cure or treat patients. Instead, they evaluate the patient\u2019s current condition and provide the means by which the patient can perform their normal occupations. Occupations in this case are defined as the every day activities of the patient.<\/p><\/div><div class=\"fusion-clearfix\">\u00a0<\/div><\/div><\/div><\/div><\/div><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-5 fusion-flex-container fusion-parallax-fixed nonhundred-percent-fullwidth non-hundred-percent-height-scrolling nitro-offscreen lazyloaded\"><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-stretch fusion-flex-content-wrap\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-6 fusion_builder_column_2_3 2_3 fusion-flex-column fusion-flex-align-self-stretch\"><div class=\"fusion-column-wrapper fusion-flex-justify-content-space-around fusion-content-layout-column\"><div class=\"fusion-title title fusion-title-2 fusion-sep-none fusion-title-text fusion-title-size-paragraph\">\u00a0<\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-a6a37df e-con-full e-flex e-con e-child\" data-id=\"a6a37df\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d59b756 e-con-full e-flex e-con e-parent\" data-id=\"d59b756\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4f07f35 elementor-widget elementor-widget-heading\" data-id=\"4f07f35\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Do you have questions about thoracic outlet syndrome?\n\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-aa8282a elementor-widget elementor-widget-heading\" data-id=\"aa8282a\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">We can help!\n\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5f0959f elementor-widget elementor-widget-button\" data-id=\"5f0959f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/hlsllc.org\/tos\/contact-us-2\/\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Contact us<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-d12d189 e-con-full e-flex e-con e-parent\" data-id=\"d12d189\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-1192877 e-con-full e-flex e-con e-child\" data-id=\"1192877\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8550ebf elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"8550ebf\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-abcef97 elementor-widget elementor-widget-heading\" data-id=\"abcef97\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Acupuncture\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d2fb61d elementor-widget elementor-widget-text-editor\" data-id=\"d2fb61d\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-title title fusion-title-text fusion-title-size-paragraph\"><div class=\"fusion-text\"><div class=\"fusion-li-item-content\"><div class=\"fusion-text fusion-text-3\"><div class=\"fusion-text fusion-text-10\"><div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-7 nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\"><div class=\"fusion-builder-row fusion-row\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-8 fusion_builder_column_1_1 1_1 fusion-one-full fusion-column-first fusion-column-last\"><div class=\"fusion-column-wrapper fusion-flex-column-wrapper-legacy\"><div class=\"fusion-text fusion-text-7\"><div class=\"fusion-text fusion-text-8\"><div class=\"fusion-text fusion-text-13\"><p>Many people have seen images of a person being treated with a number of tiny needles in their skin. Traditional acupuncture practitioners believe that the chi (pronounced \u2018chee\u2019) in the body must be balanced. Neuroscientists suggest that the needles stimulate nerves or blood vessels, or perhaps stimulate release of the body\u2019s natural pain relievers. Acupuncture has been deemed effective by organizations such as the World Health Organization (WHO) and the National Center for Complementary and Integrative Health (NCCIH)\u00a0in the treatment of a number of conditions, including headache, low back pain, rheumatoid arthritis, knee pain and neck pain. There is not a large volume of scientific evidence supporting the effectiveness of acupuncture, but many patients experience relief from acupuncture treatments. Acupuncture may provide significant additional relief in\u00a0neurogenic TOS patients receiving other conservative treatments. Most states require non-physician acupuncturists to pass a qualifying examination.<\/p><\/div><div class=\"fusion-text fusion-text-14\">\u00a0<\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div><\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-12b5a3f elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"12b5a3f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-907bde9 elementor-widget elementor-widget-heading\" data-id=\"907bde9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Massage Therapy\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-82df7df elementor-widget elementor-widget-text-editor\" data-id=\"82df7df\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<div class=\"fusion-text fusion-text-15\"><p>Massage therapy performed in conjunction with other conservative treatments may increase effectiveness of those treatments. Scientific studies of massage therapy are often preliminary and conflicting. However, there is some evidence that massage therapy may provide relief for patients with chronic neck pain or low back pain, knee pain, or depression. Massage therapists are regulated in most states.<\/p><\/div><div class=\"fusion-text fusion-text-16\">\u00a0<\/div>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e1b0e01 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"e1b0e01\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-150d959 elementor-widget elementor-widget-heading\" data-id=\"150d959\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Scalene Block\n<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-68147a6 elementor-widget elementor-widget-text-editor\" data-id=\"68147a6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<p>Gage and Parnell in 1947 likely performed the first anterior scalene block. In 1998, the procedure was revisited by Jordan and Machleder. Currently. a number of TOS surgeons rely on this procedure to make surgical decisions.<\/p><p>A doctor performs a scalene block by injecting a medication into the anterior scalene muscle. Doctors may choose a short-acting anesthetic for diagnostic purposes, or a longer-acting agent for temporary relief of pain. In addition to the anterior scalene muscle, some doctors inject the middle scalene muscle, the subclavius muscle, or the pectoralis minor muscle.<\/p><p>No clear evidence has been published regarding the mechanism that creates relief of symptoms from these injections. There are varying levels of evidence regarding the effectiveness of these injections. Nonetheless, at least empirically, many TOS patients do experience relief from these injections.<\/p><p>More discussion to follow regarding these injections.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3c895bc elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"3c895bc\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9d380e1 elementor-widget elementor-widget-button\" data-id=\"9d380e1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#top\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-angle-right\" viewBox=\"0 0 256 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M224.3 273l-136 136c-9.4 9.4-24.6 9.4-33.9 0l-22.6-22.6c-9.4-9.4-9.4-24.6 0-33.9l96.4-96.4-96.4-96.4c-9.4-9.4-9.4-24.6 0-33.9L54.3 103c9.4-9.4 24.6-9.4 33.9 0l136 136c9.5 9.4 9.5 24.6.1 34z\"><\/path><\/svg>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Back to Top<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-3afee44 e-con-full e-flex e-con e-child\" data-id=\"3afee44\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Conservative Treatment of Neurogenic Thoracic Outlet Syndrome Conservative treatment of neurogenic thoracic outlet syndrome remains the primary treatment modality Conservative treatment remains the primary approach in almost all patients with\u00a0neurogenic thoracic outlet syndrome.\u00a0Treatment of neurogenic thoracic outlet syndrome\u00a0rarely, if ever, represents a surgical emergency. 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