Frozen Shoulder and Thoracic Outlet Syndrome

Our osteopath healthcare practitioners are experts in treating frozen shoulder, thoracic outlet syndrome and related conditions of the shoulder, neck and thorax. We are a leading osteopathic clinic run by Robin Lansman, a past president of the Institute of Osteopathy and regular guest on BBC TV and radio, and treatment is available at both our West Hampstead and Maidenhead clinics, with easy online booking, and online video consultations also available. We can also advise you on workplace health and other factors to prevent the problem recurring.

Frozen shoulder, TOS and related conditions are complicated complaints which are frequently misdiagnosed. We are experts in understanding the complex and fine interplay between the upper ribs, the mechanics of breathing, postural muscles and the brachial plexus bundle of nerves that runs between the neck and the whole arm providing power and sensation to the area. We can provide an accurate diagnosis of your problem and treat the underlying cause, which is often not where the problem presents.

At our London clinic we work closely with the medical staff at Doctor Today, allowing us preferential access to services such as blood tests and x-rays where necessary. All our osteopaths attend regular continuing professional development, ensuring everyone is up to date with the latest treatments and research.

Frozen Shoulder is a particular manifestation of shoulder pain where the shoulder becomes stiff and painful. It can occur when the shoulder is not moved very much, for example after an operation, or can occur without any obvious cause.

Thoracic Outlet Syndrome occurs when there is tension or pressure on the nerves which lead from the thorax into the arm and shoulder. This can cause similar symptoms such as stiffness and pain, as well as other symptoms like pins and needles in the arm or cold feelings in the fingers.

While symptoms may be similar for various types of shoulder, neck and arm pain, getting to the root cause of the problem is essential for treatment to be effective.

Pressure on the nerves in the thoracic outlet can lead to various sensations in the arm, including numbness, cold feelings or pins and needs in the arm and fingers, or a “dead arm”. All of these can be symptoms that the root cause of your shoulder or arm pain is pressure on the thoracic nerves, which can usually be relieved with appropriate physical therapy.

Sudden pins and needles in the arm can also be a sign of a heart attack. If you are in any doubt call 999 immediately.

A frequent symptom of frozen shoulder, TOS and related conditions is that the pain can wake you up at night. This may also be accompanied by numbness, etc.

In addition to physical therapy, heat treatment is often used to alleviate symptoms at night, and also finding the right pillow and mattress. Many people suffering from these conditions tend to start using higher pillows as it initially causes relief from the problem and makes it easier to sleep. Over time however, the less natural sleeping position can further exacerbate problems with the nerves in the thorax and upper arm, causing the pain to worsen.

Your osteopath will be able to advise you on the best pillow and mattress, and help you not only sleep better but ensure your sleeping position is most conducive to a full recovery.

Unfortunately many treatments for shoulder pain and related conditions provide a “one-size-fits-all” approach to treatment. Painkillers are often prescribed, providing temporary relief but no improvement in the underlying problem, or in more extreme cases steroid injections may be used, which again whilst relieving symptoms on a short-term basis do nothing to help on the longer term if the cause is nerve-related rather than simple swelling. Similarly, patients may also be given generic exercises to do which have not been designed specifically for their unique problem and can serve to make the underlying problem worse. In some cases these treatments may continue to be given for months or even years with little or no improvement.

Understanding the underlying causes of your condition and dealing with them directly is essential in effective treatment for frozen shoulder or similar conditions. An accurate diagnosis and appropriate physical therapy, combined with any necessary lifestyle changes, allows treatment to get to the root of your problem, relaxing muscles or addressing joint misalignment which may be the fundamental cause of your pain and stiffness.

Osteopathy is a hands-on therapy that uses a variety of techniques including spinal manipulation and soft tissue work, such as massage and myofascial release. Many osteopaths also use dry needling. The aim is to improve strength, flexibility, and alignment of the musculoskeletal system. Osteopathy is a holistic treatment, meaning it looks at the functioning of the body as a whole rather than only looking at individual parts. This is crucial when diagnosing nerve-related thorax and arm pain, as the source of the problem is frequently not where the pain or numbness is felt.

At your first appointment your osteopath will listen to you explain your symptoms and proceed to a full examination of both any affected areas and your general body biomechanics. Your osteopath will then be able to give you an accurate diagnosis of the causes of your shoulder, neck or arm pain, explaining whether it is caused by problems with thoracic nerves, simple muscular tension, or any other reason. They will also explain an appropriate treatment plan of physical therapy, which will typically include manipulation, mobilisation and stretching of the affected areas, soft tissue work, and exercises to do at home.

Osteopaths are experts in posture and overall body mechanics, so we will also be able to identify whether your problem is leading to negative compensatory reactions elsewhere in the body, for example leading to neck pain, back pain or headaches, and work to address these also.

Osteopaths are Allied Health Professionals who also work in musculoskeletal departments of the NHS, and First Contact Practitioners, able to refer you to another service when osteopathy is not the most appropriate method of treatment.

You might also want to take a look at our first visit expectations to see what to expect on your first visit to an osteopath.

We have clinics in West Hampstead and Maidenhead and our osteopaths have many years experience in treating frozen shoulder, TOS and related conditions. We are registered with the General Osteopathic Council, and offer treatment in accordance with NICE guidelines.

We pride ourselves on our 6-step treatment process and ensuring that you are listened-to and involved at every step of your treatment, that you understand the treatments you are being given, and are informed as to your progress and how long your recovery is likely to take. We also offer diagnostic appointments via online video consultations, offering a quick and easy way to obtain a professional diagnosis.

Your lifestyle and comfort during your recovery is also important, and we will advise you on factors like how to sleep with your condition, whether and when to take painkillers or use things like heat pads, whether activities like yoga and pilates can help, and the best mattress, chair and so on. We will also give you specialised exercises and stretches for your unique case.