Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a term that refers to three related syndromes involving compression of the nerves, arteries, and veins in the lower neck and upper chest area. It occurs when nerves or blood vessels are compressed by the rib, collarbone or neck muscles at the top of the outlet. This compression causes pain in the arm, shoulder, and neck.

Thoracic Outlet Syndrome
Thoracic Outlet Syndrome
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Your Guide to Understanding Thoracic Outlet Syndrome

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome (TOS) is a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. This can cause pain in your shoulders and neck, numbness in your fingers, and even a weakened grip. TOS can be caused by injury, physical trauma, poor posture, repetitive arm movements, or anatomical defects, and treatment may involve physical therapy, pain management, and in some cases, surgery to relieve pressure on the affected nerves or blood vessels.

How can Physiotherapy help treat Thoracic Outlet Syndrome?

A physiotherapist can help treat thoracic outlet syndrome by designing a personalized exercise program to improve posture, strengthen muscles, and enhance flexibility in the affected area. They may also utilize manual therapy techniques to reduce muscle tightness and joint stiffness, as well as provide education on ergonomics and lifestyle modifications to prevent exacerbation of symptoms.

Physiotherapists may employ techniques such as nerve gliding exercises to alleviate nerve compression and improve overall function in the affected area. It's important to seek guidance from a qualified healthcare professional for an individualized treatment plan.

What causes Thoracic Outlet Syndrome?

Thoracic outlet syndrome (TOS) is typically caused by compression of the nerves, arteries, or veins in the lower neck and upper chest area. This compression can be a result of anatomical defects such as an extra rib, poor posture, repetitive arm movements, trauma from a car accident or other injuries, or even activities that involve repetitive use of the arms and shoulders. Additionally, TOS can be caused by muscular hypertrophy or tightness, leading to compression of the thoracic outlet structures.

What treatments might help Thoracic Outlet Syndrome?

Treatment for thoracic outlet syndrome (TOS) aims to alleviate symptoms, improve function, and address the underlying cause. Common approaches to TOS treatment include:

  • Physical therapy focusing on posture improvement
  • Muscle strengthening and mobility enhancement
  • Medication such as nonsteroidal anti-inflammatory drugs (NSAIDs) or muscle relaxants for pain and inflammation management
  • Surgical intervention like thoracic outlet decompression in cases where conservative measures are ineffective
  • Self-care strategies including ergonomic adjustments, posture correction, and lifestyle modifications
  • Occupational therapy to develop coping strategies for daily tasks and strain reduction
  • Nerve blocks or injections for pain management and temporary relief management of underlying conditions such as cervical ribs, poor posture, or muscular imbalances
  • Patient education to understand the condition and its triggers.

Signs of Thoracic Outlet Syndrome:

Thoracic outlet syndrome (TOS) manifests with a range of signs and symptoms, including numbness or tingling in the arm or fingers, weakness in the arm or hand, pain or aching in the neck, shoulder, or arm, swelling or discoloration of the arm, impaired circulation to the arm or hand, arm fatigue, and hand clumsiness or cold sensitivity. It's important to note that symptoms can vary depending on the specific type of TOS (neurogenic, vascular, or non-specific) and individual factors.

Symptoms of Thoracic Outlet Syndrome:

TOS encompasses a spectrum of symptoms, including numbness or tingling in the arm or fingers, pain or aches in the neck, shoulder, arm, or hand, arm fatigue with activity, weak grip, swelling of the affected limb, coldness of the hand, change in hand color, dull aching pain in the neck, shoulder, and arm, cold feeling or other signs of poor circulation in the forearm or hand, sores on the fingers or hands, neck, shoulder, or arm pain, atrophy of the intrinsic hand muscles, and weakness in the arm. These symptoms can vary based on the specific type of TOS and individual factors.

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When is the right time to see a Physiotherapist for Thoracic Outlet Syndrome?

The right time to see a physiotherapist for thoracic outlet syndrome is typically at the onset of symptoms or upon diagnosis, especially in cases of neurogenic thoracic outlet syndrome. Conservative management involving physical therapy is often the initial treatment strategy, aiming to address posture, flexibility, and strength to alleviate symptoms and prevent further complications.

Meet our Lead Registered Physiotherapist

Brittany Pereira

Brittany Pereira

Registered Physiotherapist

Registered Physiotherapist with a degree from the University of Toronto

Brittany enjoys working with patients across age groups and backgrounds to help them move better, get stronger, understand their bodies and ultimately, feel more confident. She combines her knowledge and clinical experience to best serve her patients.

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Physiotherapist Brittany Pereira working with client at Anchor Health and Performance Clinic Mississauga
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