Thoracic Outlet Syndrome

By Dr. Paul Thomas
Updated 2024-03-09 07:12:53 | Published 2022-02-28 06:07:29
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    • Explore the Diseases category on iMedix for comprehensive insights into various health conditions. This section offers detailed information on symptoms, causes, treatments, and preventive measures, providing a valuable resource for understanding and managing health challenges.

An abstract illustration of Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is a condition that occurs when the nerves or blood vessels in the thoracic outlet, a space between the collarbone and first rib, become compressed. This compression can cause pain and discomfort in the neck, shoulder, and arm, as well as weakness and numbness.

Thoracic Outlet Syndrome

What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome (TOS) is a group of disorders that occur when blood vessels or nerves in the thoracic outlet — the space between your collarbone and your first rib — become compressed. This can cause pain in your shoulders and neck and numbness in your fingers.

What are the symptoms of Thoracic Outlet Syndrome?

Common symptoms of TOS include neck, shoulder, and arm pain, numbness or tingling in the fingers, weakened grip, and swelling or discoloration of the arm. The type and severity of symptoms can vary depending on whether nerves or blood vessels are compressed.

What causes Thoracic Outlet Syndrome?

TOS can be caused by physical trauma from a car accident, repetitive injuries from job- or sports-related activities, certain anatomical defects (such as having an extra rib), and sometimes pregnancy. Poor posture and obesity can also contribute to the development of TOS.

How is Thoracic Outlet Syndrome diagnosed?

Diagnosing TOS involves a physical exam and medical history evaluation. Your doctor may also order imaging tests like X-rays, ultrasound, CT scans, or MRI to view the structures of your thoracic outlet and identify any abnormalities. Nerve conduction studies can also be helpful.

What are the treatment options for Thoracic Outlet Syndrome?

Treatment for TOS may include physical therapy, pain relief medications, exercises to improve posture and strengthen muscles, and in some cases, surgery. The specific treatment depends on the type of TOS and the severity of symptoms.

Can Thoracic Outlet Syndrome be prevented?

While not all cases of TOS can be prevented, maintaining good posture, avoiding repetitive strain, and doing exercises to strengthen the shoulder and neck muscles can help reduce the risk. It's also important for individuals in high-risk professions to take regular breaks and use ergonomic devices.

Is Thoracic Outlet Syndrome a common condition?

TOS is relatively uncommon, but its prevalence may be underestimated due to misdiagnosis or lack of recognition. It's more frequently diagnosed in young adults and is generally more common in women than in men. The true incidence of TOS is difficult to determine due to the variability of symptoms and diagnostic criteria.

TOS can be categorized into three types: neurogenic, vascular, and nonspecific. Neurogenic TOS is the most common form, where the brachial plexus (a network of nerves that control the muscles and sensations in the shoulder, arm, and hand) is compressed. Vascular TOS involves the compression of blood vessels, leading to limited blood flow and potential clotting. Nonspecific TOS refers to cases without a specific cause.

Common symptoms of TOS include pain, tingling, and numbness in the neck, shoulder, arm, or hand, muscle weakness, and swelling in the affected area. Symptoms can be aggravated by certain movements, such as raising the arms or carrying heavy objects.

The causes of TOS can vary and may include physical trauma, poor posture, repetitive activity, obesity, anatomical abnormalities, and tumors. It is more common in women and individuals who perform repetitive overhead motions or engage in activities that strain the neck and shoulders.

Diagnosis of TOS involves medical history evaluation, physical examination, and various imaging tests such as X-rays, MRIs, and CT scans. Treatment options include conservative measures like physical therapy, pain management, and lifestyle modifications to reduce strain. In some cases, surgery might be necessary to relieve compression on the affected nerves or blood vessels.

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It is important for individuals experiencing symptoms of TOS to seek medical attention for an accurate diagnosis and appropriate treatment plan. With timely intervention, most TOS cases can be effectively managed, leading to improved quality of life and reduced discomfort.

Thoracic Outlet Syndrome

  • Arm pain and weakness
  • Tingling or numbness in the fingers or hands
  • Muscle wasting
  • Poor hand coordination
  • Headaches
  • Dizziness or lightheadedness
  • Swelling or discoloration in the hand or arm
  • Neck pain and stiffness
  • Pain or aching in the shoulder or upper back
  • Tenderness in the affected area
  • Difficulty gripping or holding objects
  • Weak pulse


  • Anatomy: The abnormal anatomy of the thoracic outlet can compress and impinge on the nerves or blood vessels, leading to Thoracic Outlet Syndrome.
  • Poor posture: Prolonged slouching, hunching over a desk, or carrying heavy backpacks can contribute to muscle imbalances and compression of the thoracic outlet.
  • Trauma: Accidents, such as car crashes or other injuries that impact the shoulder area, can cause damage to the structures of the thoracic outlet.
  • Repetitive movements: Engaging in repetitive activities or motions, like typing or lifting heavy objects, can strain the muscles and contribute to the development of Thoracic Outlet Syndrome.
  • Pregnancy: Hormonal changes and weight gain during pregnancy can increase the pressure on the thoracic outlet, leading to the syndrome.
  • Tumors or growths: Abnormal growths, such as tumors or cysts, in the neck or upper chest can put pressure on the structures of the thoracic outlet, resulting in Thoracic Outlet Syndrome.
  • Genetics: Some individuals may be born with a predisposition to develop Thoracic Outlet Syndrome due to inherited anatomical variations or connective tissue disorders.
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