Thoracic Outlet Syndrome
By Sydney CBD Osteopath Dr Abbey Davidson
What is Thoracic Outlet Syndrome?
The thoracic outlet is made up of your collar bone, first rib, first thoracic bone and the very top of the breast bone. 
Thoracic Outlet Syndrome, otherwise known as TOS, is a condition that results from pressure applied to nerves and blood vessels as they exit the thorax and travel to the upper limb from the lower neck. This pressure can come from muscle tension (especially in the pectoralis and scalene muscles), poor posture, congenital anomalies and trauma. TOS is more common in females, especially those between the age of 20-40.
What are the signs & symptoms of Thoracic Outlet Syndrome?
You may have Thoracic Outlet Syndrome if you are experiencing one or multiple of the following symptoms.
- Numbness & tingling in the arm (especially into the pinkie and ring finger)
- Loss of colour in the hand (pallor or blue colouration)
- Cold fingers/arms
- Lower neck/upper shoulder pain
- Weak pulse in the arm
What you can do to help yourself with Thoracic Outlet Syndrome?
The best way in which you can help yourself with TOS is to attempt to correct your desk and sleeping posture. Being stuck in poor posture for multiple hours can make you predisposed to TOS and its symptoms. Ergonomic changes (ask for an ergonomic assessment if necessary) and conscious effort to improve posture can reduce the pressure placed on the effected blood vessels and nerves. Stretches which open the chest and lengthen the pec and scalene muscles are also encouraged. You can ask your health practitioner for further instruction for these if required.
Other adjuncts which may be useful are heat pack application, which promotes blood flow and muscle relaxation, and maintenance of a healthy weight.
For more information on Thoracic Outlet Syndrome, check out the video below by Sydney CBD Osteopath Dr Abbey Davidson, or click here.
When should I see a health-professional for Thoracic Outlet Syndrome?
You should see a health professional, such as a physiotherapist, osteopath, or chiropractor if you are experiencing one or more of the following:
- Pain, numbness, tingling or discolouration is getting worse or not improving
- Difficulty perform normal daily activities
- Fatigue or weakness in the effected arm
- Muscle wasting in the arm or hand
What your health professional will do to help with Thoracic Outlet Syndrome?
After a history of the complaint is taken, your health professional will assess the thoracic outlet and surrounding areas for restriction and muscle tension. Orthopaedic tests will also be performed to provoke your symptoms, assess pulse strength and rule out other diagnoses. In some cases, you may be sent for further imaging.
Then, your health professional will use techniques which aim to free the path of effected nerves and blood vessels. Treatment will address underlying posture issues, open your chest, reduce tension in your scalene and pectoralis muscles, improve your spinal range of motion and educate you on how to best manage your TOS until your next session.
For other conditions of the neck and thoracic spine, click on the conditions below:
- Neck Pain
- Neck Pain due to Poor Posture
- Whiplash
- Torticollis
- Cervical Radiculopathy (Pinched Nerve)
- Facet Sprains
- Cervical Osteoarthritis (Neck Arthritis)