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Thoracic Outlet Syndrome (TOS)

What is TOS?

Thoracic Outlet Syndrome is the compression of the nerves and/or blood vessels as they exit the neck and go into the arm. Commonly, the individual experiences pain and discomfort in their neck and upper back that radiates into their arms and down to their fingers.

What causes TOS?

Thoracic outlet syndrome (TOS) can be caused by muscle imbalance due to faulty posture (eg: spending a lot of time using the computer and mobile phones) in the neck area and sometimes due to bony anomalies like the presence of a cervical rib or an elevated 1st rib. These muscle imbalances and bony anomalies compress the brachial plexus (network of nerves that come from the cervical region) and/or the blood vessels (arteries and veins) supplying the arm and hand.

What are the signs and symptoms of TOS:

TOS is divided into two categories: Neurogenic and Vascular
  • Neurogenic: If the involved structures affect the brachial plexus, the person will experience sharp and shooting pain, numbness, or tingling sensations from the neck radiating down to the arm and fingers. More often, these symptoms are felt at night or sometimes while working in front of a computer.
  • Vascular: If the involved structures affect the blood vessels, the individual will experience coolness and paleness on the affected arm. They could also have a weak or absent pulse.
Other signs and symptoms of TOS include:
  • Arm fatigue with activity, especially when working with arms overhead.
  • Decreased grip strength
  • Numbness and tingling sensation on the inner and/or outer aspects of the forearm down to the fingers.

Complications of TOS

If the condition is left untreated, the nerves and/or blood vessels will continue to be compressed, causing atrophy of muscles and structures distal to the compression. This can cause severe damage over time and surgery will be warranted to fix the problem.

When to seek help?

If a person is suffering from any of the aforementioned symptoms, they should be assessed by a regulated professional such as a physician, physiotherapist, or chiropractor to rule out other peripheral neuropathies. Other neuropathies similar to TOS are carpal tunnel syndrome, handlebar syndrome, cubital tunnel syndrome, or central neuropathies such as cervical stenosis and disk herniation.

If you suffer from thoracic outlet syndrome, you can have a consultation with one of our physiotherapists or chiropractors. Most people seeking services at CURAVITA are able to have an initial assessment on the same day or the day after. Call or book online to schedule an appointment to get answers to your questions at our CURAVITA Byward Clinic (613-860-8600) or our CURAVITA Glebe Clinic (613-237-9000).

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