NTOS and Repetitive Trauma Disorders

Abstract

The relationships between Neurogenic Thoracic Outlet Syndrome (NTOS) and the various forms of repetitive trauma disorders merit clarification. In many patients there is a link between NTOS and the various forms of repetitive trauma disorders. These disorders appear to, in part, stem from nerve involvement in the brachial plexus often related to poor posture. This in turn impairs peripheral muscle function when coupled with sustained overuse. Muscle regeneration is impaired due to a lack of activation of satellite cells located between muscle fibers and the basal lamina. Satellite cells create new muscle fibers under conditions of good circulation, intact nerve impulses and optimal hormonal factors. Our study and that of others show that about 70 % of persons with these trauma disorders have clinical evidence of NTOS. This association results in muscle damage particularly when associated with eccentric contraction of loaded stretched muscles. The degeneration-regeneration cycle of muscle is then impeded due to neurological circulatory abnormal factors decreasing the ability of satellite cells to repair damaged muscle. A logical continuum can be proposed under these circumstances linking NTOS with repetitive trauma in the peripheral nerves and muscles.