What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome (TOS) refers to a group of conditions involving compression of the nerves or blood vessels as they pass between the collarbone and first rib — an area known as the thoracic outlet. This compression can cause pain, numbness, tingling, or weakness in the shoulder, arm, and hand. TOS affects approximately 8 per 100,000 people annually, with neurogenic TOS being the most common type (Illig et al., 2016).

Common Causes

  • Poor posture or forward head position causing muscular and structural compression.
  • Repetitive overhead activities (e.g. sports, manual labour).
  • Trauma to the neck, shoulder, or upper ribs (e.g. whiplash injury).
  • Anatomical variations such as an extra cervical rib or tight scalene muscles.
  • Prolonged sitting or occupational strain involving computer or desk work.

Treatment Options

WCCC management may include:

  • Gentle chiropractic adjustments to improve neck, shoulder, and rib alignment.
  • Soft tissue therapy focusing on the scalene, pectoral, and upper back muscles to relieve tension.
  • Specific stretching and strengthening exercises to restore balance and posture.
  • Ergonomic and postural guidance for work and daily activities.
  • Collaboration with medical professionals for further assessment when vascular or severe neurological involvement is suspected.

References:

  • Illig KA, et al. Thoracic outlet syndrome. J Vasc Surg. 2016;64(3 Suppl):e23–e35.
  • Atasoy E. Thoracic outlet compression syndrome. Orthop Clin North Am. 1996;27(2):265–303.