Thoracic Outlet Syndrome: Causes, Symptoms, and Treatment

WHAT IS THORACIC OUTLET SYNDROME?

Thoracic Outlet Syndrome (TOS) is a condition that affects your neck, shoulders, arms, and hands by compressing the nerves, arteries, and blood vessels between your lower neck and shoulder. There are three types of thoracic outlet syndrome: neurogenic, venous, and arterial.

All three forms cause pain in the neck and shoulder and commonly radiating pain down your arm into your hand. Left untreated, thoracic outlet syndrome can lead to blood clots, muscle atrophy, and nerve damage.

 

WHAT ARE THE RISK FACTORS AND CAUSES OF TOS?

Thoracic Outlet Syndrome is typically caused by:

  • Poor posture

  • Obesity

  • Repetitive arm and shoulder movements

  • Anatomical abnormalities (cervical ribs)

Those who perform tasks repetitively overhead whether it be sports or work are more likely to develop TOS. Pregnant women are also at higher risk for TOS.

 

WHAT ARE THE SYMPTOMS OF THORACIC OUTLET SYNDROME?

There are three types of thoracic outlet syndrome and all three have their own signs and symptoms:

Neurogenic TOS is the most common type of thoracic outlet syndrome. This happens when your brachial plexus nerves are compressed along their path through your shoulder into your arm.

Symptoms include:

  • Pain the neck, shoulder, and arm

  • Headaches

  • Numbness or tingling in the arm or hand

  • Arm or shoulder pain when reaching or moving

  • Hand coldness and intolerance to cold.

Venous TOS develops when your subclavian vein is compressed between your clavicle and first rib, creating a blood clot. This is one of the most common vascular disorders in competitive athletes.

Symptoms include:

  • Arm swelling

  • Discoloration

  • Numbness & tingling

  • Pain

Arterial TOS is the rarest form. This type of thoracic outlet syndrome occurs when your subclavian artery is compressed, leading to aneurysms and blood clotting.

Symptoms include:

  • Hand pain

  • Coldness

  • Paleness

  • Tingling in the hand

  • Chronic arm weakness and cramping when in use.

While the three types of TOS sound familiar, a proper diagnosis can improve your condition and speed recovery.

 

TREATMENTS FOR THORACIC OUTLET SYNDROME

Proper treatment of thoracic outlet syndrome depends on getting your diagnosis correct. There are a few tests which may be done to confirm your TOS including imaging studies (MRI & diagnostic ultrasound) and nerve tests (EMG/NCV). These tests are focused on finding the specific point of the compression so it can be alleviated.

Most thoracic outlet syndrome cases respond well to conservative treatments. Physical therapy and occupational therapy are commonly recommended to fix posture and rebuild weak muscles.

Pharmaceuticals are also common treatments including over the counter pain medications, muscle relaxers, thrombolytic medications, and anticoagulant medications.

In the case you were born with a congenital varient like an extra cervical rib, surgery may be recommends. Physical therapy is typically recommended before and after surgery to improve outcomes and speed recovery. We always recommend trying conservative treatment before opting for surgery of any sort.

 

HOW PROACTIVE HEALTH CAN HELP:

THORACIC OUTLET SYNDROME DIAGNOSIS, TREATMENT, AND PAIN RELIEF

Proactive Health providers are experts in diagnosing the root cause of pain and dysfunction. Our doctors will guide you through a full body functional movement assessment which is designed to uncover movement issues that may be contributing or causing your pain. Our main treatments for thoracic outlet syndrome are hands on manual therapy combined with targeted rehab exercises focused on restoring proper function. We strive to provide you with the tools and resources to manage your pain, so you can get back to living your active, awesome life!

If you’re experiencing thoracic outlet syndrome, don’t wait. Call us at (423)779-3295 or click the button below to get started.