Thoracic Outlet Syndrome


Thoracic Outlet Syndrome (TOS) is a compression of the nerves and blood vessels that emerge from the neck and go into the arms. I recently had a friend ask about a feeling of pressure and pain in his left arm. This pain has been bothering him off and on for several months and he has been checked out to be sure it was't his heart. He saw a physical therapist for 1 visit, and left with more questions than answers with an explanation of "it's just poor posture." After listening to his story I was fairly confident that the problem is TOS. While I have not examined him directly to confirm this, I thought that his story may be useful for others who have strange symptoms in their arms/hands that are not easily explained. 

TOS can cause symptoms of numbness, tingling, pressure, or a heaviness/pressure felt in the arm and/or hands. It is often misdiagnosed as other problems such as carpal tunnel, and can be a precursor to such problems as Adhesive Capsulitis/Frozen Shoulder. The most common causes are trauma or repetitive strain injuries. Trauma may include a whiplash type injury to the neck or a fall onto the head/neck or a broken collar bone. Repetitive strain injuries are common for people who have poor ergonomic postures while performing repetitive work activities such as typing, lifting, and factory work. 

The condition of TOS is easily diagnosed through performance of simple clinical examination and correlation with expressed symptoms. If TOS is suspected following clinical examination, then radiographs can be used to confirm the diagnosis, although this does not generally change the treatment approach. 

Treatment is focused on the use of manual therapy techniques to reduce muscle spasm and myofascial adhesions, and specific strengthening and stretching exercise to reduce muscle imbalances and correct posture. Physical therapy is an ideal treatment as it encompasses these main treatment approaches and a physical therapist is trained to diagnose the condition. Relief of symptoms should occur quite rapidly with appropriate skilled treatment and results are maintained through regular performance of a targeted exercise and stretching program. 

If you have pain, numbness, tingling, pressure, or other strange sensations in the arms or hands, contact me today for an evaluation to determine if TOS is the cause. Don't wait or continue to live with the pain!

Kelley PenroseComment