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Management-Nonoperative Management

Conservative treatment is almost always the initial management, provided that no severe vascular compromise is pres-ent. Success rates for nonoperative treatment have been reported to range from 67% to 90%. Nonoperative management includes relative rest and nonsteroidal anti-inflammatory medications to reduce repetitive irritation and swelling around the nerve that may be causing the symptoms.

Postural exercise is necessary, because slouching may decrease the space that is available for the neurovascular structures. Physical therapy should focus on improving posture using postural feedback, strengthening the scapular stabilizers and depressors of the shoulder girdle and modalities. Several modalities, including ultrasound and transcutaneous nerve stimulation and biofeedback, have been recommended.

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