Awards & Recognition
St. Joseph's Executive Leadership
History of St. Joseph's
Press Center and News
Research and Education
Sponsorship Request Application
Thoracic Outlet Syndrome (TOS) is caused by the compression or “pinching” of nerves and blood vessels in the space in the lower part of the neck, above the clavicle, across the first rib, and through the upper part of the arm.
The compression of these nerves can be caused by a variety of reasons. Physical trauma (ex. Car accident, fall, etc), repetitive motion injuries secondary to job or athletic activities (weight lifting, pitching, etc) are the most common etiologies. Certain anatomic defects such as extra rib or tumors causing compression can also result in symptoms of TOS.
Individuals with occupations requiring extensive use of the upper extremities have an increased risk of developing TOS. This could vary from construction workers to dental hygienists. Proper posture training, stretching and strengthening the proper muscle groups through physical therapy are important measures that can be taken in order to prevent and treat TOS.
There are three types of TOS.
It can be difficult to pinpoint the exact cause TOS in each patient. However symptoms may include:
These symptoms may increase when the arms are extended or lifted above the shoulders. More severe cases experience constant, intense pain causing weakness, while some cases may produce only mild, intermittent occurrences of pain and numbness.
TOS can be tricky to determine and requires extensive healthcare expertise in order to diagnose properly. It is best to identify TOS early; however this is often difficult due to the rare nature of the syndrome. The diagnostic process may include:
Mild and severe cases of TOS are very treatable. At the Norton Thoracic Institute (NTI), we aim to relieve symptoms through a multidisciplinary approach. Physical therapy is a crucial part of the treatment protocol. A majority of patients can be helped by following the proper physical therapy protocols.
Treatment for mild cases of TOS include:
Physical Therapy intervention for mild cases of TOS may include:
Treatment for more severe cases of TOS include:
However, TOS is avoidable if proper precautions are taken. Stretching and regular breaks from strenuous work can not only treat TOS, but prevent the overall development of the syndrome.
It is possible to get rid of TOS completely if proper measures are taken. However when dealing with TOS, NIT suggests:
To learn more about our services, call 602.406.4000.