43-year-old Linda had been suffering from a pain in her left shoulder and chest for a month. The pain was excruciating and radiating down into her left arm. It had come on gradually over a few days without any clear incident associated with symptoms. Linda could only think of a fall about 10 days before the pain started, in which she fell on her left wrist. The doctor gave her pain killers which hadn't help at all. Then she tried a few sessions of sports massage but couldn't get any relief. The pain was still so bad that could make her cry. After some close examination, her well-trained and knowledgeable masseur suspected the condition was thoracic outlet syndrome and suggested she seek more specialist diagnosis and treatment. Couldn't wait any longer for doctors appointment, she followed a friend's advice, came to see me for acupuncture.    

What the masseur had suspected did make a lot of sense to me. Thoracic outlet syndrome (TOS) is a group of disorders that occur when there is compression, injury, or irritation of the nerves and/or blood vessels (arteries and veins) in the lower neck and upper chest area. TOS is named for the space (the thoracic outlet) between the lower neck and upper chest where this grouping of nerves and blood vessels is found. Common causes of TOS include physical trauma from a car accident, repetitive injuries from job or sports-related activities and certain anatomical defects (such as having an extra rib). Sometimes doctors can't determine the cause of TOS.

On examination, I found some tense and sensitive points in Linda's neck, shoulder and arm, then applied acupuncture and moxabastion followed by cupping. After the treatment I asked her how she was feeling. She looked tearful and said there wasn't much difference. She came back a week later for the second session and told me that, strangely, she was very emotional and teary after last treatment, but two days later the pain suddenly got much less. Now it was a milder, manageable ache with a tingle in her arm and fingers. I gave her another check and used four points which are different from what I used last time. A few days later, I had a phone call from Linda to cancel her third appointment with me because no one could help her looking after the kids on that day. She said her pain actually had almost gone. A few weeks later I saw her friend who sent her to see me. She told me that Linda has been fine.