Tratamiento fisioterápico mediante terapia manual en el síndrome compresivo del músculo escaleno: a propósito de un caso

Thoracic outlet syndrome referring to brachial plexus entrapment within the anterior and medium scalene muscle is under debate. The case of a 70-year old woman, with progressive neck and hand pain since 3 years ago is reported. She had received previous physiotherapy intervention (massage, microwave and TENS) without any effect. The Adson test was positive for the affected arm. Her treatment consisted of 8 physical therapy sessions including pressure release, mobilization of C5-T1 joints, nerve slider neurodynamic technique biased to the median nerve and cranio-cervical flexion motor control exercises. Spontaneous pain intensity at baseline was 6 points (0-10). Functionality was 40% according to the Michigan Hand Outcomes Questionnaire. One month after the last session, pain at rest was 1/10 and the Michigan Hand Outcomes Questionnaire showed 75% hand function. Physiotherapy focused on manual therapy approach represents a potential effective intervention for reducing symptoms and increasing function in individuals with thoracic outlet syndrome.