According to Souza, which of the following is NOT considered conservative management for TOS?

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For thoracic outlet syndrome, the nonoperative approach focuses on reducing the mechanical compression through soft-tissue release, flexibility, and proper shoulder–neck mechanics. Myofascial therapy targets tight scalene and pectoralis minor muscles that crowd the outlet, helping to lessen the pressure on nearby nerves and vessels. Preventative exercises and stretching keep the shoulder girdle and chest flexible and balanced, reducing the risk of re‑compression with arm movements. Postural training addresses alignment issues like rounded shoulders and forward head posture that narrow the thoracic outlet and contribute to symptoms during activity.

Cervical traction isn’t considered part of conservative management for TOS because it primarily aims to decompress the cervical spine rather than the thoracic outlet itself. It doesn’t reliably address the specific tightness and dynamic compression within the outlet and, in some cases, can worsen symptoms. Therefore, it’s not listed among the standard conservative strategies for TOS.