Thoracic Outlet Syndrome

The thoracic outlet is the ring formed by the top ribs, just below the collarbone.

Thoracic outlet syndrome (TOS) occurs when blood vessels or nerves are compressed by the rib, collar bone or neck muscles a the top of the outlet. This can cause shoulder and neck pain as well as numbness in the fingers. 

There are a number of different causes of TOS these include;

  • Congenital abnormality such as an extra rib or abnormal muscle/first rib formation.
  • Physical trauma such as whiplash.
  • Bodybuilding.
  • Repeated overhead motions such as those done by swimmers, hair stylists, and auto mechanics. 
  • Weight gain.
  • Neck tumour.

Neurogenic TOS
This is the most common type the compression of the brachial plexus. This can result in numbness or tingling in arm or fingers, pain or aches in neck and shoulder, and a weakening grip.

Venous TOS
Occurs when one or more veins are compressed. This leads to upper body thrombosis. Approximately 5% of TOS are venous.

Arterial TOS
The least common type, with only 1% of all TOS. Arterial TOS is the result of an artery being compressed. This can lead to a bulging artery or aneurysm. Symptoms of this include; cold fingers, hands or arms, hand and arm pain, lack of colour or bluish appearance in one or more fingers, and weak or no pulse to the affected arm.

Although unlikely, it is possible to have a mix of all three. 

Depending on the type of TOS you are experiencing the treatment may differ. Hands-on physical therapy in combination with a home exercise program may be suitable to relieve symptoms and reverse the cause. Other treatment options may include medications, botox, and in extreme cases surgery.

As always, prevention is key. Avoiding repetitive movements overhead, ensuring you keep correct posture, maintaining a healthy weight and ensuring correct form when exercising may help you to reduce your chances of developing a form of TOS.

Should you be worried about the risk of developing TOS, come and see one of our experienced therapists. They will be able to assess you and assist in developing an exercise program to help reduce your risk.

To book an appointment you can call our friendly team on 9578 6588 or click the button below.