04/11/2024
Thoracic outlet syndrome, also known as TOS, is when there is compression of the bundle of nerves, veins, and arteries that run between the first rib and the collar bone. This compression can be caused by a trauma to the area, repetitive use injury, chronic abnormal posture or abnormal anatomy. Symptoms can vary depending on which structures are being compressed. There are four types of TOS.
Category 1: Arterial TOS symptoms include pain in the hand but not in shoulder or neck, coldness or cold intolerance, numbness and tingling, and symptoms worsen when the involved arm and hand is over the head.
Category 2: Venous TOS symptoms include pain and swelling in the arm, bluish discoloration of the arm, tingling and numbness in fingers and hands, and symptoms are worse when the involved arm and hand is over the head.
Category 3: Ture neurogenic TOS symptoms include pain, numbness, and tingling in the hand, arm, shoulder, and often the neck, headaches, numbness and tingling in the arm that disturbs sleep, clumsiness of the hand, coldness and color changes in the hand, and symptoms wore when the involved arm is over the head.
Category 4: Disputed neurogenic TOS has the same symptoms as a true neurogenic TOS, however testing may come back as normal.
Doppler testing and nerve conduction testing are common tests performed to diagnose TOS. However, your physical therapist may be the first to determine that you have TOS. Therapists use the patient’s history of injury, special tests, and assessment of function to determine if you have TOS. Based on this assessment a physical therapist can provide education, symptom relief through manual therapy and exercises, and restore function through strengthening and functional activities. If you are experiencing these symptoms, talk to your doctor about how one of our Baptist Health Therapy centers can help you!