Adson's Test or Maneuver for Thoracic Outlet Syndrome

The individual is requested to sit erect at the end of the table with their hands placed in their lap, their shoulders back and looking directly ahead (Military posture), while the practitioner monitors the radial pulse on the effected side. After establishing pulse rate, the individual is requested to take a deep breath and rotate and extend their head as far as possible towards the unaffected side (looking toward the ceiling). Should the pulse rate significantly diminish or completely obliterate when the individual sits erect with their shoulders back, consider Costoclavicular Syndrome. Should the pulse rate diminish or obliterate upon inhalation and head extension with rotation to unaffected side, consider Scalenus Anticus Syndrome. Should cervical rib or spondylitic change be suspected, radiographs are indicated. Numerous myofascial trigger points and/or a nerve compression at the cervical thoracic junction (CT Junction) can mimic the pain of a Thoracic outlet syndrome. Hypertonic Scalenes have the ability to both entrap neurovascular supply and develop trigger points that when active result in arm and forearm pain.

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