01/07/2026
Pain, tingling, numbness, swelling down the arm?
The problem is not always where the pain is!
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Thoracic Outlet Syndrome (TOS) involves compression of the brachial plexus (nerves), subclavian artery, or vein at specific narrow spaces in the shoulder/neck region, and self-treatment focuses on stretching tight muscles, improving posture, and mobilizing those spaces to reduce pressure.
Scalene Anterior Syndrome
The brachial plexus passes through the narrow interscalene triangle (between anterior/middle scalene muscles and first rib), where increased tone in the anterior scalene, scarring from trauma, or cervical spine issues can compress it.
Self-treatment includes scalene stretches: Sit tall, side-bend neck away from the affected side while gently tucking chin, holding 30 seconds; or use a strap over the shoulder pulled toward the opposite hip to enhance the stretch.
Pectoralis Minor Syndrome (Hyperabduction Syndrome)
Compression occurs under the pectoralis minor tendon at the coracoid process, worst with arm abduction/overhead but also from tight pecs or poor posture even at rest.
Try pec minor stretches: Lie on a foam roller along your spine, let arms fall open with elbows bent and palms up, exhale and hold 30 seconds; or stand in a doorway with forearms on the frame and lean forward.
Costoclavicular Syndrome
The neurovascular bundle gets pinched between the clavicle and first rib, often bilateral from symmetrical posture issues like kyphosis or shallow breathing.
Mobilize with first-rib self-mobs: Drape a strap over the shoulder, pull down toward opposite hip, side-bend neck to affected side, and take 10 deep breaths to caudal glide the rib; add scapular retraction/depression holds.
Common Causes & Signs
Causes include muscular hypertonicity/postural dysfunction (e.g., forward rounding), trauma/scarring, crutch use, trigger points, repetitive stress, or emotional factors leading to shallow breathing/poor sleep posture.
Signs feature arm/forearm/hand/finger paresthesia (numbness/tingling), often unilateral but bilateral with posture; scalene type may add hand/finger edema.