Thoracic Outlet Syndrome

Manual therapy is an external approach in which a therapist uses their hands to relax soft tissues and correct joint alignment. If the effect is only temporary, it may indicate that while superficial muscles are relaxed, deep fascial adhesions and fibrosis remain—such as between the scalene muscles or beneath the pectoralis minor—leading to recurring nerve compression. Acupuncture with needles (Dochim) differs in that it is an invasive treatment that directly reaches these adhesion sites to finely incise and dissect hardened tissue; it allows for the treatment of deep lesions that cannot be reached by manual techniques alone. In Korean medicine, recurring numbness is viewed as going beyond simple muscle tension to a stage where stagnant, dead blood has hardened into a fixed, adherent form (adhesion). While simple tension returns to normal after release, tissue hardened by clotted dead blood must be physically broken to be relieved. At Dongjedang, we enhance safety by using fine needles to detach adhered tissue while confirming the location of nerves and blood vessels with ultrasound. Following the dissection, we proceed with the next steps: thermal stimulation acupuncture to strengthen ligaments, insertion of dissolvable sutures, and pharmacopuncture for anti-inflammatory effects. Simultaneously, we combine this with herbal medicine treatment to cleanse the body and correct the constitution, preventing the re-accumulation of stagnant waste and dead blood. Our clinical perspective is that only by addressing local ailments alongside restoring systemic circulation can we avoid the temporary results often found in treatments focused solely on manual techniques.