Thoracic Outlet Syndrome (TOS)

Written By Ben Davidson

Thoracic Outlet Syndrome (TOS) refers to the compression of the neurovascular structures (nerves and blood vessels) in the space between the clavicle (collar bone) and the first rib. This can cause pain in the shoulders and neck, and numbness in the fingers. Evidence suggests that 95% of cases involve the nerves, rather than the blood vessels.

Types of Thoracic Outlet Syndrome

TOS is an umbrella term to describe a group of disorders of the thoracic outlet. Symptoms vary depending on which nerve or blood vessel is compressed.

  • Neurological Thoracic Outlet Syndrome (most common) is characterised by compression of the brachial plexus. These nerves run down the shoulder, arm and hand.

  • Venous Thoracic Outlet Syndrome occurs due to compression of the veins under the clavicle causing blood clots.

  • Arterial Thoracic Outlet Syndrome (most rare) occurs with compression of the Subclavian artery (the artery under the collarbone) causing an aneurysm.

What causes Thoracic Outlet Syndrome?

Females are more likely to develop TOS than males, with typical diagnosis between the ages of 20 to 50. Some common causes of nerve or blood vessel compression include:

  •  Trauma eg. Car accident

  • Repetitive activity eg. Job related, sport related

  • Anatomical defects such as a cervical rib – this narrows the space for the blood vessels and nerves

  • Poor posture – Rounded shoulders and kyphotic posture narrows the thoracic outlet and tightens the muscles at the front of the neck

  • Pressure on the joints – this can occur from carrying a backpack or being overweight

  • Pregnancy – hormones released in pregnancy cause ligaments around joints to relax. This can include the joints around the thoracic outlet

Treatment

As the types, cause and symptoms of thoracic outlet syndrome (TOS) vary, it is important to see a medical professional if you notice any signs of the condition. You may be referred for scans to detect and accurately determine diagnosis.

At Lakelands Health and Performance, our Chiropractor tailors a unique treatment plan to aid in your recovery through:

•           Soft tissue mobilisations (massage)

•           Stretching exercises

•           Restoring range of movement

•           Postural improvement

•           Dry Needling

•           Taping

•           Shockwave Therapy

•           A unique home exercise program

•           Graded Exposure to load program

Ben Davidson
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