Thoracic Outlet Syndrome

What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome is a group of disorders of the shoulder that are the result of compression of vessels or nerves located between the clavicle and the first rib. The space between the clavicle and the first rib is commonly known as the ‘thoracic outlet’.

Symptoms of TOS

Compression of the nerves in the thoracic outlet will affect nerve transmission and health of the affected nerves. Common symptoms of nerve compression in thoracic outlet syndrome include:

• pain in the neck, shoulder, arm or hand
• numbness or paresthesia (tingling) in the arm, hand or fingers
• weakness in the grip
• muscle wasting, especially of the thumb muscles, if present for a prolonged period of time

Compression of the vessels in the area will reduce circulation to the affected arm and hand. Common symptoms of vessel compression in thoracic outlet syndrome include:

• coldness in the hand
• redness in the arm and/or hand
• swelling in the arm and/or hand
• loss of strength and endurance in the arm and/or hand

Common causes / contributing factors of thoracic outlet syndrome:

• traumatic injury
• poor posture
• obesity
• tumor
• overuse, especially activities involving having the arms overhead for prolonged periods of time
• an extra rib / cervical rib

How do you diagnose Thoracic Outlet Syndrome?

There are orthopedic tests that can be used to help diagnose thoracic outlet syndrome. These tests include:

• Roos Test
• Adson’s Test / Adson’s Maneuver