Upper Back and Neck

Thoracic Outlet Syndrome

Definition: Thoracic outlet syndrome (TOS) is a condition that involves the compression of the brachial plexus or subclavian vessels as they pass through narrow passageways leading from the base of the neck to the armpit and arm.

Causes: There may be a bony callus or cervical rib present, or caused by compression such as crutches. Other causes include prolonged poor positioning, poor posture, systemic immune or metabolic disorders (such as rheumatoid arthritis, diabetes and hypothyroidism), trauma, joint subluxation of the cervical spine, or pregnancy.

Signs and Symptoms: Can be neurological or vascular. There may be primarily a neurological compression of the brachial plexus, or a vascular compression of the subclavian artery and vein and the lymphatic vessel, or a combination of both.

Symptoms with a Nerve Compression: Numbness and tingling are primarily on the inner side of the hand, especially in the fingers and possibly the inner forearm. The altered sensation can spread to the entire hand. If the compression goes untreated permanent damage can result. Diffuse, aching or throbbing pain is experienced in the upper limb, mostly the shoulder, and in the forearm and hand. Pain is worsened by letting the arm hang down, carrying or lifting heavy objects or raising the arm above the head. The pain is relieved by lying down.

Symptoms with a Vascular Compression: Pallor is present, a weak or absent pulse in the affected arm, which also may be cool to the touch and appear paler than the unaffected arm. Symptoms may include numbness, tingling, aching, and heaviness.

Treatment: Physiotherapy, massage therapy, with exercises to strengthen chest muscles, restore normal posture, and relieve compression by increasing the space of the area the nerve passes through.

For more information or to book an appointment call 604-524-4446.


1). National Institute Of Neurological Disorders And Stroke.

2). Clinical Massage Therapy: Understanding, Assessing and Treating Over 70 Conditions, Copyright Rattray Ludwig, 2005 Talus Inc.


Definition: Whiplash is pain and stiffness in the neck after an injury that has caused the neck to move suddenly or beyond its normal range. It occurs when the head is suddenly forced backward or forward and is then snapped in the other direction.

Causes: This kind of motion most often happens to people in a car that is hit from behind. Less commonly, it might happen in a fall, a sports injury, or if you are roughly shaken. The motion causes stretching or tears (sprains) of muscles and ligaments in the neck, and it may damage the nerves. In rare cases, it may cause broken bones.

Signs and Symptoms: Pain and stiffness in the neck and can include the muscles of the head, chest, shoulders and arms. The muscles of the neck may suffer spasm and contusion. Whiplash can result in blunt head trauma, loss of consciousness and post-concussion headache. Other possible symptoms include deafness, dizziness, headache, memory loss, nausea, temporomandibular joint pain, thoracic outlet syndrome, tinnitus and difficulty swallowing.

Treatment: Clinical experience suggests that a combination of complementary therapies optimizes the client’s recovery. Chiropractic, massage therapy, physiotherapy and acupuncture are examples of therapies that should be considered. It takes up to 3 months for the neck to heal, even though most pain may be gone in less time. More severe whiplash may take longer, but it usually improves within 6 to 12 months.

After your neck pain is gone, do exercises to stretch your neck and back and make them stronger. Your physiotherapist or massage therapist can tell you which exercises are best

How can you prevent whiplash?

To help prevent whiplash when you drive, always wear your seat belt and adjust your headrest to the proper height.

For more information or to book an appointment call 604-524-4446.


1). Emedicinehealth.

2). Clinical Massage Therapy: Understanding, Assessing and Treating Over 70 Conditions, Copyright Rattray Ludwig, 2005 Talus Inc.

Upper Back Pain

Definition: Upper back pain is pain that is felt from the base of the neck to the top of the lower back (lumbar spine).

Causes: Upper back pain can result from sudden injury, lack of strength, repetitive strain, poor posture, or joint dysfunction. Working long hours on the computer is one example of repetitive strain. Sudden injuries include sports injuries or car accidents. There could also be a problem with the joints between the vertebrae and ribs. In women over the age of 50, a compression fracture from osteoporosis should be considered. Less common causes include a spinal disc herniation, or degenerative disc disease. Upper back pain is not as prevalent as lower back pain.

Treatment: Stretching and strengthening exercises are very important in rehabilitation. Osteopathy or chiropractic treatments, as well as physiotherapy are indicated for joint dysfunction. Deep massage therapy is very effective in working out trigger points.

For more information, or to book an appointment call 604-524-4446.


1). spine-health.com.

2). Wikipedia.org.