Common Conditions

Thoracic Outlet Syndrome

Thoracic Outlet Syndrome therapy

Thoracic Outlet Syndrome (TOS) is a relatively rare condition but is commonly missed or misdiagnosed. It involves compression to the nerve or blood vessels deep within the shoulder and neck.

Our team are skilled at screening for TOS and providing strategies for this condition. Thoracic Outlet Syndrome commonly presents between the ages of 20 and 40 years. Symptoms will vary (depending on the cause) from vague shoulder and arm pain to a “dead arm” sensation with the arm feeling like it “goes to sleep.” Other symptoms can include blood flow issues with colour changes in your hand or forearm.

There are two distinct types of the problem. One is when there is a blood flow problem in or out of the arm. The other type is when nerves are compressed by structures in and around the shoulder and neck. Both types can cause different symptoms.


How Can Our Hand Therapists Help?

We are able to perform a very comprehensive assessment to determine if you do in fact have TOS. We might consider asking you to see a GP or specialist to have further investigations if you have not already had them, guiding you in the right direction for diagnosis.

We can devise a custom management program to treat Thoracic Outlet Syndrome conservatively. Core principles of a home program are learning the key strategies (Crosby & Wehbe, 2004) which are posture for function, positioning your body to prevent pressure on the compressed nerve, breathing techniques, relaxation strategies and a graded / tailored exercise program.

Interesting Fact

Some people are born with an extra rib called a cervical rib. This can be linked to cause Thoracic Outlet Syndrome. A simple chest X-ray can usually determine if you have one. In some cases of severe Thoracic Outlet Syndrome, the extra rib and the first rib are surgically removed.


Crosby, C. A., & Wehbe, M. A. (2004). Conservative treatment for thoracic outlet syndrome. Hand Clinics, 20(1), 43-49.

Examples of
Solutions to Try

While these are general examples, our hand therapists will help match solutions best suited to your condition and specific needs.

A face-to-face consultation will allow for thorough investigation.

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