Understanding Thoracic Outlet Syndrome – 5 Treatment Options To Achieve A Breakthrough In Pain, Numbness and Tingling

This article is an update to a previously written article that can be found here -> Tingling hands, tight muscles and bad posture – the untold story of Thoracic Outlet Syndrome

Are you tired of living with the constant agony and limitations of Thoracic Outlet Syndrome (TOS)?

Don’t let this debilitating condition hold you back any longer!

We understand the immense pain and frustration you’re going through, but there’s hope. In this article, we will dive deeper into the description, common symptoms, and treatment options for Thoracic Outlet Syndrome.

What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome (TOS) is a relatively rare but potentially debilitating condition that affects the nerves and blood vessels in the region of the thoracic outlet. This area is located between the base of the neck and the armpit. This complex disorder can lead to a range of symptoms, causing pain and discomfort in the upper body.

The thoracic outlet is a narrow passageway that lies between the collarbone (clavicle) and the first rib. Within this space, nerves, arteries, and veins pass through on their way from the chest to the arms. Thoracic Outlet Syndrome occurs when the structures in this area become compressed or irritated, resulting in various symptoms. We see people who work as mechanics, hair dressers, construction work to name a few who are impacted because they work with their arms raised over their shoulders

3 Types of Thoracic Outlet Syndrome

Neurogenic Thoracic Outlet Syndrome (NTOS): This is the most common type, characterized by the compression of the brachial plexus, a network of nerves that controls movement and sensation in the arm.
Vascular Thoracic Outlet Syndrome (VTOS): In VTOS, the compression affects the subclavian artery or veins, leading to reduced blood flow and potential clotting.
Nonspecific Thoracic Outlet Syndrome (NTOS): This type is less well-defined and encompasses a combination of nerve, artery, and vein compression.

Common Symptoms of Thoracic Outlet Syndrome

The symptoms of TOS can vary depending on the type and severity of the condition. However, some common symptoms experienced by individuals with TOS include:

Pain and discomfort: Persistent pain in the neck, shoulder, and arm is a hallmark of TOS. The pain may be sharp, burning, or throbbing in nature, and can extend to the fingers. The intensity of the pain may worsen with specific arm movements or prolonged arm use, especially those with the hands and arms over head.
Numbness and tingling: Many individuals with TOS experience sensations of numbness, tingling, or “pins and needles” in the arm, hand, and fingers. This occurs due to nerve compression or irritation.
Muscle weakness: Weakness in the arm or hand muscles may occur as a result of nerve involvement in Thoracic Outlet Syndrome. It can lead to difficulty with gripping objects, performing fine motor tasks, or even weakness in the entire arm.
Swelling and discoloration: Vascular TOS can cause swelling in the affected arm, hand, or fingers. The affected limb may also appear bluish or reddish in color due to compromised blood flow.
Cold sensitivity: Some individuals with TOS may experience increased sensitivity to cold temperatures in the affected arm, hand, or fingers. This occurs due to decreased blood circulation.

Treatment Options for Thoracic Outlet Syndrome

The treatment of TOS generally involves a combination of conservative measures and, in severe cases, surgical intervention. The approach to treatment is tailored to the specific type and underlying cause of TOS.

1- Physiotherapy

Physiotherapy plays a crucial role in the management of TOS. Therapeutic exercises aim to strengthen the muscles around the thoracic outlet, improve posture, and relieve compression on the affected structures. Manual techniques such as stretching and soft tissue mobilization are also often used to treat this condition.

2- Pain management

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help alleviate pain and reduce inflammation associated with TOS. In more severe cases, your primary care physician may prescribe stronger pain medications or muscle relaxants. Similarly, using a device like a TENS machine may provide some temporary relief of symptoms.

3- Posture correction

Correcting poor posture can alleviate pressure on the thoracic outlet. Ergonomic modifications at workstations, including proper chair height, desk setup, and keyboard positioning, can be beneficial. For more tips on proper posture please click here.

4- Nerve gliding exercises

If nerves don’t move well along their pathway, this can cause issues with them being easily irritated giving off the feeling of pins and needles, numbness, weakness, etc. Nerve gliding exercises involve specific movements to promote the gliding of nerves through their surrounding tissues. Nerve gliding exercises can help reduce nerve irritation and improve symptoms.

5- Surgical intervention

In cases where conservative treatments fail to provide relief, surgical intervention may be necessary. The specific procedure will depend on the underlying cause of TOS. Surgery aims to alleviate compression or remove any anatomical abnormalities causing TOS.

Wait No Longer

Thoracic Outlet Syndrome can cause significant discomfort and functional limitations for individuals affected by the condition. Recognizing the common symptoms and seeking early intervention is crucial for an accurate diagnosis and appropriate treatment. With a comprehensive approach that includes physiotherapy, pain management, and, in severe cases, surgery, many individuals can find relief and regain their quality of life. If you suspect you may have TOS, consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.

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Jason Bellefleur

Jason Bellefleur is a multi-award-winning physiotherapist. Most recently, he was recognized as a 2016 Ottawa Forty Under 40 recipient and received numerous awards from the Orléans Chamber of Commerce (the 2011 Young Business Person of the Year, the 2012 Healthcare Professional of the Year and the 2014 Business Person of the Year awards). Jason is proud to be an Orléans resident and to raise his family in a bilingual community. He enthusiastically promotes local business within the Orléans area and frequently supports and participates in local events. Jason was recognized for his community involvement by receiving the Orleans 150 Community Builder award in 2017 by Ottawa-Orléans MPP Marie-France Lalonde. Jason firmly believes in high-quality one-on-one physiotherapy interventions. His treatment approach emphasizes hands-on intervention, continued client education, and active involvement by the individual to help them reach their full potential. By opening a clinic that offers 'Higher Standards of Care,' Jason wants his patients to feel confident that they receive the highest level of patient care available. As a result, he is also preventing injury and helping to improve their health and well-being.