back to list Thoracic Outlet Syndrome Thoracic outlet syndrome, or TOS, gets its name from the space (the thoracic outlet) between your collarbone (clavicle) and your first rib. This is a narrow passageway that is filled and crowded with blood vessels, muscles, and nerves. Entrapment, or pinching, of these structures can occur for a number of reasons. If the shoulder muscles are not strong enough to hold the collarbone in place, it can slip down and forward, putting pressure on the nerves and vessels that lie under it. This is very common in someone who is chronically slouching. You can also get this condition from overdeveloping the pectoral muscles at the expense of the muscles of the back of the shoulder. Again, this causes entrapment of the nerves and vessels in the tunnel. Another cause of this can be either your work position, slouching over a desk, or your sleep position (rolling on the shoulder). The symptoms of thoracic outlet vary, depending on whether nerves, or blood vessels, or both are being compressed. Pressure on the blood vessels can reduce the flow of blood to your arms and hands, making them feel cool and tire easily; or on the veins, causing edema or swelling of the hand. Pressure on the nerves can, at a minimum, leave you with a vague, aching pain in your neck, shoulder, arm or hand. In other cases, it can cause severe weakness of the muscles of the forearm and hand. If you have this condition, you may find overhead activities being particularly difficult. Sleeping on your side may cause your lower arm to "fall asleep." Thoracic outlet can result from a number of causes. These can run the gamut from a local injury, to muscle weakness, to muscle over development. Poor posture and obesity aggravate this condition and it is more common in women than in men. Many claim that psychological changes are often seen in patients with thoracic outlet syndrome. This condition is often found in the person who looks as though the weight of the world is bearing down on his/her shoulders. Diagnosis A complex of muscle therapies will usually be needed to stretch and open the outlet and to strengthen the muscles to help prevent reoccurrence. The correct therapy for you will depend on the findings of your examination. Your posture during the day and how you sleep are very important in correcting and controlling this condition. Surgery is seldom needed. While this condition increases in frequency as we age, it is not inevitable that you will experience it. If you do, working together we can reduce the symptoms. If you are not yet experiencing the symptoms of TOS, with proper posture and sleep patterns, you can work toward preventing it.
Do you have general ache or numbness in the arm? Do you wake with your hand numb or asleep? Are your arms weaker than they used to be? Do you have problems working with your arms up in front of you? Are you slumping over? There are many possible causes of these symptoms, and they can range from problems in the neck, to a condition known as thoracic outlet syndrome. “Poor posture and obesity aggravate this condition
and it is more common in women than in men.”
The diagnosis of this condition starts with the history of your symptoms. Testing is then done to recreate the symptoms of thoracic outlet, or to alleviate them. For example, if you have the symptoms lying on your side, muscle testing will show weakness when you are in that position. If you have weakness in your arms when you are bent over, then straightening your posture will strengthen weakness in the hands. Muscle testing is one of best tools for diagnosing the existence of entrapment of the nerves in the thoracic outlet. Determining what causes the changes in muscle function will help us to create the therapy program that is correct for you. “The diagnosis of this condition starts with the history of your symptoms.”
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