Tingling hands, tight muscles and bad posture – the untold story of Thoracic Outlet Syndrome

**An update on this topic can be found here -> Understanding Thoracic Outlet Syndrome – 5 Treatment Options To Achieve A Breakthrough In Pain, Numbness and Tingling **

Tingling hands, tight muscles and bad posture – the untold story of Thoracic Outlet Syndrome

Are you experiencing numbness or tingling in both hands when you are raising your arms over your head, washing/drying your hair, during prolonged cleaning or overhead activities? You may be experiencing the symptoms of condition called thoracic outlet syndrome. Now you might be asking what that is exactly since it is not a common condition like tennis elbow or carpal tunnel syndrome. This blog aims at shedding light on this often overlooked condition.

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome or TOS is a process that usually involves the compression or pinching of a bundle of nerves and blood vessels located at the base of the neck and in the shoulder. Compression often happens because of a congenital or acquired change in the bones or soft tissues around this area. Sites of potential compression can happen at the following locations:

-Under or through the scalene triangle

-Between the collar bone (clavicle) and the first rib

-The small pectoral (pectoralis minor) muscle if these muscles are too tight

3 Types of Thoracic Outlet Syndrome

1. 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.
2. Vascular Thoracic Outlet Syndrome (VTOS): In VTOS, the compression affects the subclavian artery or veins, leading to reduced blood flow and potential clotting.
3. Nonspecific Thoracic Outlet Syndrome (NTOS): This type is less well-defined and encompasses a combination of nerve, artery, and vein compression.

In 1% of the population and 10% of cases of Thoracic Outlet Syndrome, there is the presence of an extra rib above the others that compresses this bundle. Poor posture such as having head and shoulders forward can also be a contributing factor. TOS can also appear as a result of a shoulder injury (ex: motor vehicle accident) or repetitive overhead activity. The symptoms can be quite vast and it can sometimes be hard to diagnose.

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:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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

Now what can you do about it? First of all, the easiest thing that we can work on is maintaining good posture. Keep your head back and shoulders rolled slightly backward and downward. Instantly you will feel like you are standing more upright. This on its own can improve your symptoms greatly.

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.

In some cases, it might be a good idea to ask your doctor about a nerve conduction study in order to see if any of the nervous pathways are affected by Thoracic Outlet Syndrome.

Surgery can also be an option if the problem is longstanding and not responding to any treatment. A conservative treatment is always recommended before any type of drastic measure such as surgery.

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.