Another reason to stop slouching at work

All about thoracic outlet syndrome.

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Hi, it's Lindsay in Los Angeles, where I recently went down a rabbit hole to diagnose a mysterious shooting pain that started in my chest. More on that in a moment, but first ...  Today's must-reads US health insurer shares tumbled on news Medicare Advantage payments would be flat in 2027. UnitedHealth forecast its first annual revenue drop in more than three decades. Israel is going through its biggest mental-health crisis ever over Gaza. Posturing I wasn't doing anything particularly strenuous when I felt the first stab of pain right around my heart. In fact, I had barely moved for hours, camped out in my desk chair waiting for a piece of news to drop that was far behind schedule. Small movements like rolling my shoulders or twisting in my seat made me wince.  The news event finally came and went, but the pain persisted into the next day.  Many Google searches later, I stumbled upon a condition I had never heard of that seemed to perfectly describe my symptoms: thoracic outlet syndrome. Google, of course, can only get you so far on health issues, though it did reveal the fun fact that TOS can mimic some of the sensations of a heart attack. A coworker happened to know one of the busiest thoracic outlet surgeons in the country, so I caught up with him to learn more.  The thoracic outlet, explains Northwestern Medicine surgeon Jason Ko, is a tight space between the neck, chest and shoulder through which a bundle of nerves running from the cervical spine and major blood vessels from the heart pass. In most cases of TOS, certain repetitive arm movements or positions cause the pectoralis minor and surrounding muscles to tighten and compress those nerves and vessels, which then can kick off a host of symptoms including chest and neck pain, numbness or tingling in the arms and fingers, and muscle weakness. Accidents and trauma to the area can also cause TOS. In my case, I had simply slouched my way into the situation by tensely sitting for so long in front of my computer. Ko says it can be a difficult condition to diagnose because patients will often visit their primary care physicians complaining of vague symptoms, and none of the typical static tests — X-rays, CT scans, MRIs — reveal a problem. Even electromyograms, which measure the electrical activity in the nerves and muscles, can miss TOS. Specialists who look out for the syndrome, however, can perform a neurogram, among other tests, to identify kinking and compression in the nerves running from the spine down to the arm. Ko himself has dealt with TOS for years due to his posture at work. "We as surgeons do horrible things to our necks during surgery," he says.  The good news is, most of the time physical therapy is the first line of treatment. It's what has helped Ko avoid undergoing the very surgery that's his specialty. Botox injections to relax the muscles are also an option. If none of the above works, Ko will discuss peripheral nerve surgery with patients.  For Ko personally, a twice-daily routine of stretches has kept the pain at bay. That and a "weirdo neck pillow" that keeps his shoulders, back and neck from aggressively turning during the night. I've now got YouTube stretching videos bookmarked. But "weirdo neck pillow" is a whole other Internet rabbit hole. — Lindsay Blakely What we're reading These nine influencers are shaping health information online, for better or worse, STAT reports. The CDC has stopped updating dozens of vaccine- and disease-related databases, according to NBC. Kanye West apologized for his antisemitic behavior, blaming it on bipolar disorder, People writes. Contact Prognosis Health questions? Have a tip that we should investigate? Contact us at AskPrognosis@bloomberg.net. Follow us You received this message because you are subscribed to Bloomberg's Prognosis newsletter. If a friend forwarded you this message, sign up here to get it in your inbox. Unsubscribe Bloomberg.com Contact Us Bloomberg L.P. 731 Lexington Avenue New York, NY 10022 |