What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome is a group of conditions that arises from the compression or irritation of the nerves and/or blood vessels (called the ‘Thoracic Outlet’) that serve the arms.

Two categories of Thoracic Outlet Syndrome exist:

• Vascular Thoracic Outlet Syndrome – compression of the blood vessels (2% of cases)
• Neurological Thoracic Outlet Syndrome – compression of the nerves (98% of cases)

The structures most at risk of compression are the subclavian artery, subclavian vein and the brachial plexus (nerves serving the arms).

The above structures can become compressed at the following locations:

• Between the middle and anterior scalene muscles at the front of the neck
• Between the clavicle and 1^st rib
• Beneath the coracoid process of the scapula (shoulder blade)
• Beneath the pectoralis minor muscle of the chest

Causes of Thoracic Outlet Syndrome

• Poor posture such as Upper Crossed Syndrome (the linked article touches on this)
• Anatomical defects such as a “cervical rib” (bony growth on vertebrae above first rib)
• Physical trauma
• Weight lifting
• Weight gain

Symptoms

• Numbness and/or tingling in the effected arm and/or hand
• Arm, neck and shoulder pain on the effected side
• Weakness in the effected arm and shoulder
• Discoloration of the effected arm (vascular category)

Treatment

In most cases of Thoracic outlet syndrome, conservative treatment is very effective. This consists of:

• Thorough examination of physical influences such as posture, muscular imbalance etc.
• Understanding of possible lifestyle influences such as work and sporting activities
• Hands on treatment to relieve symptoms and assist with postural correction
• Ergonomic desk setup advice where applicable
• Individualised rehabilitation exercises where necessary

For some relevant self help advice watch my video to learn the stretch your neck properly