Treating Thoracic Outlet Syndrome

Treating thoracic outlet syndrome. Three thing you should know, and how an Exercise Physiologist can help you to regain full function.

1. What is thoracic outlet syndrome? (TOS)

Thoracic outlet syndrome (TOS) is a term that refers to three related syndromes involving compression of the nerves, arteries, and veins in the lower neck and upper chest area. This compression causes pain in the arm, shoulder, and neck.

There are 3 types of TOS:

• Neurogenic TOS.

• Venous TOS

• Arterial TOS.

2. What are the symptoms?

Unfortunately, the evidence revolving thoracic outlet syndrome is a mess.

TOS provides inconsistent symptoms, presenting a challenge for health providers to diagnose or give an accurate prognosis.

Neurogenic TOS risk factors:

• Neck, shoulder, and arm discomfort at rest; tingling sensations; night pain; weakness; and headaches at the back of the head are common symptoms. 

• Discomfort and tingling worsen with overhead movements, and some may experience reduced grip strength or finger dexterity.

Venous TOS risk factors:

• Widespread pain in the shoulder, neck, and arm may include symptoms such as swelling, bluish discolouration, and a feeling of heaviness. 

• Non-dermatomal tingling in the fingers and hand is also commonly reported.

Arterial TOS risk factors:

• Paresthesias in the fingers and hands are common, with coldness and cold intolerance as primary concerns. 

• Overhead movements can worsen symptoms, potentially causing pallor and pulselessness in the hand.

3. How can we treat it?

Treatment focuses on exercise and education, targeting:

• Pain self-efficacy improvement.

• Reduction of fear avoidance behaviour.

• Increased opportunities for daily activities.

• Enhanced tissue tolerance through progressive overload.

• Restoration of movement and range of motion.

• Desensitization of nociceptive structures by avoiding provocative positions.

Summary

An exercise physiologist can help with treating Thoracic Outlet Syndrome (TOS) by:

• Reducing pain and improving mobility

• Strengthening muscles around the neck, shoulders, and upper back to relieve pressure on nerves and blood vessels

• Improving posture to reduce strain on the thoracic outlet

• Enhancing flexibility with targeted stretches to boost circulation and nerve health

• Restoring function by focusing on strength, mobility, and daily movement

Want an individualised, non-invasive approach to restoring full function? Get in contact with us today to see how we can help.