Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is a general term that is used to describe three separate conditions that occur in the neck and upper chest area. TOS can be tricky to diagnose because there is no concrete diagnostic test to confirm this condition and the condition itself tends to be vague. Most cases of TOS involve the nerve bundle in the neck region called the brachial plexus (see picture) getting pinched from the 1st rib below. This can cause symptoms of pain down the arm, numbness or tingling down the arm, or feelings of fatigue or weakness in the arm. Many patients can get scared when they are told they have thoracic outlet syndrome but in reality all it really means in most cases is that someone has an elevated first rib (or an extra rib) that is causing compression on the nerve bundle in the neck region causing symptoms. This is treatable in physical therapy. In physical therapy we use various techniques to alleviate the pressure on the nerve bundle to alleviate symptoms. We work to mobilize the first rib back down so it is not causing compression on the nerves, we work to alleviate tight muscles such as the scalenes and the upper traps because if these muscles are tight they can pull the first rib up into the nerve bundle, we work on retraining the nerve and promoting blood flow to the nerve so it can heal, and then we work on strengthening smaller postural muscles that keep the 1st rib down away from the nerve bundle. Treatment for Thoracic Outlet Syndrome tends to get excellent results in physical therapy. Please see below for some examples of techniques we use to alleviate symptoms of Thoracic Outlet Syndrome. If you would like to schedule an appointment please reach out to us.