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What is Thoracic Outlet Syndrome: Signs, Symptoms & Treatment

Hands on Therapy

There are a number of reasons why patients would visit and consult us here at Hands on Therapy. From mallet finger to frozen shoulder, there are different sources and causes of pain and discomfort. Another condition we sometimes see is thoracic outlet syndrome (TOS). The term is not thrown around a lot, but if you experience pain, numbness, weakness in your upper extremities, shoulder, and neck, there is a possibility that you may have it. 

In this post, we’ll discuss in detail what thoracic outlet syndrome is and how physical or occupational therapy in Miami can help improve this condition.


What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome refers to the combination of three conditions that occur when nerves and/or blood vessels in the thoracic outlet get compressed. Now, what is the thoracic outlet? 

The thoracic outlet is the ring or narrow space just below the collarbone and above the top ribs. Nerves, muscles, and blood vessels extend from the back, to the arm, then to the thoracic outlet. When any of them are compressed by the collarbone, neck muscles, or rib, thoracic outlet syndrome occurs. This happens more often and commonly than you might imagine because the thoracic outlet is very narrow. The increased pressure on the nerves and blood vessels can result in pain, numbness, and tingling in your arms, neck, and shoulders. 


What Are the Types of Thoracic Outlet Syndrome?

As mentioned above, thoracic outlet syndrome refers to any one of these three types:

  • Neurogenic thoracic outlet syndrome. This type of TOS occurs when nerves that go along the neck and arm are compressed. This is the most common type of TOS.
  • Venous thoracic outlet syndrome. This type of TOS results from the compression of a vein in the thoracic outlet. It leads to upper body thrombosis. About 5% of TOS cases are classified as venous TOS.
  • Arterial thoracic outlet syndrome. This type of TOS occurs when an artery is compressed. This is rare — only around 1% of TOS cases are arterial TOS.

In some cases, venous and arterial TOS may happen at the same time. This is called vascular TOS.


What Causes Thoracic Outlet Syndrome?

The exact cause of thoracic outlet syndrome isn’t always clear. There is not one single cause for it. However, it may be a result of physical trauma from an accident. Repetitive movements and structural abnormalities of the involved body parts may also be blamed. However, what’s certain is it occurs when sensitive components get compressed. This compression can be caused by the following:

Obesity and Poor Posture

People who often slouch and don’t stand up straight can have a narrowed thoracic outlet. The same can happen to people who are overweight.

Overuse of Arms and Shoulders

Repetitive activities such as lifting heavy objects and working at a computer for long hours can damage the tissues in the thoracic outlet. In time, the tissues may shrink and compress nerves, arteries, and veins.

Extra Rib

Some people may be born with an extra rib, also called a cervical rib. This further reduces the size of the thoracic outlet.


If you recently got involved in an accident, body parts that make up the thoracic outlet can be compressed and lead to thoracic outlet syndrome.


What are the Symptoms of Thoracic Outlet Syndrome?

TOS symptoms vary depending on which blood vessel or nerve is compressed and how compressed they are. In general, someone with TOS may experience the following:

  • If a nerve is compressed, you may feel pain in the hand, arm, shoulder or neck. It may be accompanied by numbness and tingling.
  • If a blood vessel is compressed, you may have swelling and redness in the arm because of the reduced blood flow.
  • A person with TOS will have difficulty doing overhead activities as it can worsen all types of TOS.
  • There could be swelling or discoloration in the arm and depression in the shoulder.
  • Limited range of motion.


How is Thoracic Outlet Syndrome Diagnosed?

Proper diagnosis is vital in getting the right treatment. If you feel any symptoms, you should consult a doctor. They will perform a physical exam and evaluate your symptoms. Typically, your doctor will require an X-ray of the thoracic outlet to see if you have an extra rib. An MRI may also be requested to get a clearer image of the thoracic outlet. 


How is Thoracic Outlet Syndrome Treated?

The goal of thoracic outlet syndrome treatment is to relieve pain and ease the other symptoms. Below are the treatment methods that may be recommended by your doctor:

  • First-line treatments. 

These include over-the-counter pain relief medications. In some cases, thrombolytic drugs are also prescribed.

  • Physical therapy. 

Your doctor may also recommend physical therapy to help stretch and strengthen the shoulder muscles. We offer physical therapy in Doral for patients dealing with TOS.

  • Surgery. 

In very rare cases, surgery may be needed if first-line treatments and physical therapy do not help improve the symptoms.


Hands on Therapy Provides Physical Therapy for Thoracic Outlet Syndrome

If you are looking for a physical or occupational therapist to help you with thoracic outlet syndrome, you’ve come to the right place! Our physical, occupational, and hand therapists in Miami are certified and experienced to help manage your symptoms. 

Schedule an appointment today so we can get started in planning your treatment plan. You can also request a free discovery visit or alternatively, set up a telehealth appointment.

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment.  Always seek the advice of your physician or other qualified healthcare provider with any questions or concerns you may have regarding your health.

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