A recent case study describes the role of chiropractic and conservative treatments in managing a vascular disorder called Paget-Schroetter Syndrome.
Paget-Schroetter Syndrome, also called effort thrombosis, is a rare condition that occurs when a blood clot forms inside one of the veins of the upper body, in a process called deep vein thrombosis. The blood clot can be caused by compression of the venous system due to anatomical abnormalities, repetitive trauma, or thoracic outlet syndrome.
Despite its rare incidence, Paget-Schroetter Syndrome is considered the most common vascular disorder in athletes. It occurs more often in young males than woman. PSS can appear spontaneously in otherwise healthy individuals after vigorous exercise or repetitive motions like extreme shoulder abduction or rotation. Symptoms may include arm swelling, skin discoloration, warmth, and a sudden onset of pain in the neck, shoulder, or arm. PSS can cause significant discomfort, and may lead to serious or potentially fatal complications, so it’s crucial that patients seek early treatment.
Treatment for Paget-Schroetter Syndrome includes anticoagulation with heparin and warfarin, and possibly surgery. However even after initial treatment and anticoagulation, patients may continue to experience ongoing discomfort.
Case Study on Paget-Schroetter Syndrome and Chiropractic
A new case study outlines how chiropractic care helped two patients with PSS.
One patient was a 36-year old female film producer who presented at a chiropractic clinic with neck, shoulder, and arm pain. Her symptoms were related to her history of PSS and residual thoracic outlet syndrome. A chiropractor treated her with soft tissue therapy, spinal manipulation of the thoracic and lumbar spine, and posture training. Two months after treatment, the patient reported significant improvements in symptoms.
Another patient in the study was a 44-year old male guitar player who suffered from chest tension and severe pain in his upper back and arm. After a chest radiograph reveled normal results, he was diagnosed with gastroesophageal reflux disease and prescribed medication by his physician. When he continued to experience pain, he visited a chiropractor who performed additional diagnostic testing and referred the man for ultrasonography. This imaging revealed he had a blood clot in his brachial vein (where he usually rests his guitar strap) and was immediately started on anticoagulation therapy. A chiropractor was able to successfully diagnose this patient when other doctors had missed the symptoms of PSS. This enabled the patient to receive appropriate care.
This case study suggests that chiropractors can play an important role in the diagnosis and treatment of Paget-Schroetter Syndrome.
Stainsby BE, et al. Upper extremity deep vein thrombosis presenting to a chiropractic clinic: a descriptoin of 2 cases. Journal of Chiropractic Medicine 2012; 11(4): 286–292.