Thoracic outlet syndrome may be, if you’re like most people, a combination of words you’ve never heard before. Allow us to break it down for you- thoracic outlet syndrome, or TOS, is a type of chest pain that can cause pain in the shoulders and neck, and radiate numbness, weakness, and coldness into the fingers. Read on to learn more about TOS.

What is Thoracic Outlet Syndrome (TOS)?

To learn about thoracic outlet syndrome, we first have to define what the thoracic outlet is. The thoracic outlet is the area of the body located within the lower part of the neck, beginning just above and behind your clavicle, and extending to the upper part of the arm, surrounded by the collarbone and the first row of ribs. This circle of space is filled with nerves, vessels, and soft tissues that give your shoulders a sturdy range of motion.

When an injury or a specific condition occurs to this area, it can cause the blood vessels to compress. Normally, the thoracic outlet is wide enough for your nerves and blood vessels to pass through with ease, so this compression can cause pain in the neck, upper chest, shoulder or arm. This is the beginning of thoracic outlet syndrome, or TOS. 

What are the symptoms of TOS?

Thoracic Outlet Syndrome is actually much more complicated than just nerve compression. There are actually three main types of TOS: 

• Neurogenic TOS - This occurs when the nerves controlling motion in arms and hands are compressed. These nerves run from the neck to the arm, called the brachial plexus. The majority of cases are neurogenic, which can sometimes be managed with physical therapy or chiropractic.
• Venous TOS - This is when a vein is compressed, which can cause blood clots, or a condition known as thrombosis. Only about 5% of cases are venous. This type of TOS requires emergency management by a physician.  
• Arterial TOS - This is when an artery is compressed. This is the rarest type of TOS, and sometimes, arterial and venous TOS are known together as vascular thoracic outlet syndrome. This type of TOS also requires emergency management by a physician.  

The symptoms of TOS may vary depending on the specific affected parts, but some common symptoms include:

•  Blood clots
•  Weakness of the entire hand or arm
• Pain or swelling in the shoulder, hand, or arm
• Cold fingers or hand
• Numbness in fingers or arm
• Hand discoloration
• Weak pulse in the arm

If you’re experiencing these symptoms, it’s best to consult a physician ASAP to learn if TOS is affecting you- especially if you’ve had a traumatic injury to your neck or upper chest area recently.

What causes thoracic outlet syndrome? 

There are a few different causes of TOS. The most common ones include: 

• Trauma; It includes traumatic incidents such as a car accident or sudden fall.
• Repetitive activity; The repetitive shoulder and arm motion in swimming, golf, and baseball can lead to this disorder.
• Sleep complications.
• Poor posture; Drooping shoulders or keeping your head inclined forward for an extended period can also contribute.
• Depression or stress; this can lead to tension and pain. 
• Tumors.
• Anatomical defects.

Thoracic outlet syndrome- how can I treat it?

Fortunately, not everyone with this condition will require surgery. If you are experiencing Neurogenic TOS, physical therapy or chiropractic care may be able to get you back on the right track by using a combination of postural advice, manipulation, mobilization, soft tissue therapy, and at-home rehabilitation.  This seems to be the best recipe for these cases. 

At BC + PT, our chiropractors and physical therapists can work together to coordinate your care.  A great perk of BC + PT is that the chiropractor and Physical therapist can be in the same building!

If you have been suffering from TOS, it's time to take the leap and get some help. Give the doctors here at BC + PT a call today for excellent, high quality care that can’t be beat!