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Thoracic Outlet    Syndrome

Thoracic Outlet Syndrome (TOS) is a group of conditions related to the compression of blood vessels or nerves in the thoracic outlet (the space between your first rib and collarbone). Symptoms include neck, shoulder, and/or arm pain and numbness in the fingers. Possible causes of TOS include repetitive injuries from work or sports, physical trauma (e.g. from a vehicle accident), anatomical defects (e.g. having an extra rib), excess joint pressure (e.g. from carrying heavy loads such as a backpack), or pregnancy.

There are two major subdivisions of TOS: neurological and venous. Neurological TOS is the most common and results in general pain and weaknesses in the areas indicated above. The venous variant presents with swelling and generalized pain. Each variant is caused by either nerve compressions (neurological TOS) or blood vessel compression (veinous). Localization of signs and symptoms depend on the compression of specific structure.

General signs and indications of TOS include:

  • Numbness or “pins and needles” in your hands
  • Generalized aches and pains in your shoulder, neck, and arms
  • Loss of grip strength
  • Discolouration of the hand (a bluish tinge)
  • Paleness in the hand
  • Cold hands or arms
  • Weakness of shoulder, arm, or neck
  • Swelling of the arms

General risk factors for TOS include:

  • Age: those between the ages of 18-40 are most likely present with TOS
  • Sex: women are more likely to present with TOS than males

Treatment for TOS depends on the nature of the vessels compressed and severity of symptoms. Physiotherapy and pain management may be recommended by your physician. Surgery may also be an option. To learn about our treatments for TOS, please move to the next page.

This website provides general information about our services and conditions treated. It is not intended to be used for self-assessment or treatment, and is not a substitute for an individualized treatment plan developed by a registered physiotherapist.

By the Action Potential Rehabilitation Staff

Page last reviewed: June 2, 2023