Thoracic Outlet Syndrome (TOS)

Situation: Thoracic Outlet Syndrome—also called T-O-S—is a compression of the nerve and blood vessels as they pass from the neck to the arms. There are three types of thoracic outlet syndrome. Each type of TOS is named for the structures involved.


The T-O-S condition is known as scalene syndrome refers to the scalene, are a group of muscles in the neck that can compress the nerves and blood vessels as they pass from the neck to the shoulders.

The T-O-S condition classified as costo (rib) clavicular (collarbone) syndrome involves the compression of the blood vessels and nerves between the collarbone and first rib of the ribcage due to misalignment.

The T-O-S condition labeled pectoralis minor syndrome refers to the compression of blood and nerves under the pectoralis—or chest—muscle.

Symptoms: Symptoms from any T-O-S condition can cause pain, tingling, numbness or weakness into the shoulders, arms, and hands. The symptoms are mostly seen at night when compression of the shoulder is common. It is common with T-O-S to wake up with dead arm sensation. Initially, symptoms will be intermittent and self-resolving. Thoracic outlet syndrome is often misdiagnosed as carpal tunnel syndrome.

Treatment: Treatments options can include chiropractic care, acupuncture, physical therapy, and massage therapy. Your chiropractor will be able to promptly and accurately diagnose which form of TOS you are suffering from and begin the correct course of treatment.

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