Carpal Tunnel or Thoracic Outlet Symptoms
Is your pain carpal tunnel or thoracic outlet syndrome?
Many people confuse symptoms of carpal tunnel and thoracic outlet syndrome. Indeed, symptoms are similar and hard to determine which is causing the problems. Those problems include hand pain, numbness, tingling, soreness, coldness, itching and weakness. Hence, it’s important to know which condition you have in order to treat it successfully. Nobody wants to waste time and money following a treatment path for the wrong condition.
5 tests for thoracic outlet syndrome
Thoracic outlet syndrome affects about 1 in 50 people.
The symptoms of carpal tunnel & thoracic outlet syndrome are similar. Indeed, most doctors cannot tell the difference easily. There are a number of self-tests you doctor can do for with condition. Happily, you (and a partner) can also do these tests on yourself. I describe how to do self-tests for carpal tunnel in another article entitled “self-tests for carpal tunnel”.
In this article, I will show you how to perform self-tests for thoracic outlet syndrome. However, you will need a partner to help out.
By doing these tests, you can eliminate thoracic outlet syndrome as the possible cause of your symptoms. Then, you may be left with carpal tunnel syndrome as a possibility.
Test 1: Elevated Arm Stress
While seated or standing, raise both arms with elbows slightly behind your head. Then open and close your hands slowly for about 3 minutes. A positive sign will be pain, heaviness or intense arm weakness or numbness, and perhaps tingling in your hand.
TEST 2: Adson or Scalene Maneuver
While you’re standing, the helper locates your radial pulse. That’s the pulse below your wrist crease on the thumb side. Then drop your arm at a 45 degree angle. Next, rotate your head toward the tested arm. Simultaneously tilt your head backwards to extend your neck as your helper extends and holds your arm. A positive sign will be disappearance of your radial pulse.
Test 3: Costo-clavicular Maneuver
While you’re seated, the helper locates your radial pulse again, then draws your shoulder down and back as you lift your chest in an exaggerated “at attention” posture. A positive sign is an absence of your radial pulse. This test is very effective in people who complain of symptoms while wearing a heavy jacket or back-pack.
TEST 4: Allen Test
While you’re seated, the helper you locates your radial pulse again. They flex your elbow to 90 degrees while your upper arm is extended horizontally and rotated laterally (backward). You then turn your head away from the tested arm. If your radial pulse disappears as your head is rotated, it is a positive sign for thoracic outlet syndrome.
TEST 5: Provocative Elevation Test
Generally, this test is used if you already have obvious symptoms. While you’re seated, the helper grasps both arms by the elbows. You must remain passive as the helper fully elevates your shoulders in a forward position. Hold this position for 30-60 seconds. This activity will normally increase your pulse and your hand temperature. Positive signs for thoracic outlet syndrome go from numbness to pins and needles or tingling, as well as some pain. It is similar to what you might feel when your arm “falls asleep” and circulation returns.
What to do next
One or more positive signs in these tests may mean you have thoracic outlet syndrome. There are many, good physical therapy and stretching activities and maneuvers you can do to correct the condition. In some cases, the symptoms cannot be reversed. However, in most cases, diligent effort will give you good results.