Which of the following is a common initial management step for suspected thoracic outlet syndrome?

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Thoracic outlet syndrome is usually caused by mechanical compression of neurovascular structures as they pass through the space between the neck and arm. The best way to begin treatment is nonoperative rehabilitation that addresses this mechanical issue. Targeted physical therapy aims to correct posture, stretch tight scalene and pectoralis minor muscles, and strengthen the shoulder girdle while teaching nerve gliding techniques to lessen irritation. Coupled with activity modification and ergonomic changes, this approach often reduces symptoms without surgery. Surgical decompression is considered only if conservative therapy fails to relieve symptoms or if there is clear vascular involvement or progressive neurologic signs, which may require more urgent intervention. Chemotherapy and radiation therapy do not treat thoracic outlet syndrome, as they are cancer therapies and not addressing the mechanical compression at the outlet.