Physiotherapy after TOS procedure

Thoracic outlet syndrome (TOS) is a condition in which there is compression of the nerves, arteries or veins in the passageway from the lower neck to the armpit.

The shoulder muscle can be squeezed for many different reasons. Symptoms may include numbness of the upper limb, pain, stress sensitivity, limited mobility and weakness in the upper limb and shoulder area.

Surgical treatment should be considered if conservative treatment is not helpful, the patient has significant pain and/or nervous or circulatory problems. The physician evaluates the overall situation in cooperation with the patient and other healthcare staff when considering the surgery decision. Following the TOS procedure, the patient stays in Heart Hospital for an average of 1-4 days. The recovery period depends on the patient, and the length of each patient’s sick leave is determined by their circumstances.

The physiotherapy of a patient scheduled for an elective TOS procedure begins even before the surgery, when the patient’s baseline situation is established by interviewing them and performing measurements and investigations. The physiotherapist advises the patient on post-surgery issues relevant to rehabilitation. With the patient’s approval, a relative or close friend may accompany them to these appointments.

Rehabilitation starts immediately after surgery, at first assisted. The patient’s own role grows gradually. Rehabilitation begins shortly after surgery in the ward and continues at home.

Early mobility promotes recovery and doing exercise in the hospital is good medicine. After anaesthesia and bed rest, the patient is encouraged to get up and mobile, and the exercise is gradually increased as their rehabilitation progresses. Early mobility and improved breathing help the patient recover from surgery and prevent post-operative complications.

Exercise on upper body and limbs is started in the hospital. Good pain management is important for recovery. Posture, as well as symmetry and relaxation of gait after surgery are all important. The patient adheres to the instructions received in the hospital until the agreed control visit. The first physiotherapy monitoring visit is usually arranged at the patient’s own health centre about two weeks after their discharge. The total rehabilitation requires long-term effort. The patient usually has a check-up with the Heart Hospital doctors 1 month after surgery.

The physiotherapist and nursing staff instruct each patient individually on self-care after the surgery.