Think Twice: Why TOS Surgery Isn’t Always the Answer Surgery is sometimes necessary — but often patients are convinced to remove ribs or muscles for pain that may be driven by muscle guarding and inflammation. In my clinical experience, clearing the inflammation and treating the specific choke points (scalenes, under-clavicle mechanics, pectoralis minor, hyper-abduction) can produce significant improvement without irreversible surgery. Get broad, non-conflicted opinions before you agree to bone
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Wright's test for thoracic outlet syndrome (TOS) The Wright’s test is designed to decrease the retropectoralis minor space in the first step, while the second part of the test implicates the costoclavicular interval. Unclear descriptions in the performance of the Wright’s test in the study of Gillard et al. in 2001 prohibit any statement about the accuracy of this test. For this reason, the clinical value in practice is questionable. A positive result is a decrease in the radial pulse and/or rep
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