Dr. Vaishali Suri (P.T.)
What Is Thoracic Outlet Syndrome?
Thoracic outlet syndrome (TOS) occurs when the brachial plexus (network of nerves supplying the arm) and/or subclavian blood vessels are compressed in the space between the collarbone (clavicle) and first rib -- the thoracic outlet. TOS causes a variety of arm symptoms depending on whether nerves (neurogenic TOS, most common) or blood vessels (vascular TOS) are primarily affected.
Neurogenic TOS: Symptoms
Aching pain in the neck, shoulder, and arm. Numbness and tingling in the forearm, hand, and fingers (often ulnar distribution -- ring and little finger). Weakness of the hand and forearm. Symptoms often aggravated by overhead activities, carrying heavy bags, and certain neck positions. Commonly mistaken for cervical radiculopathy or carpal tunnel syndrome.
Causes
Postural: rounded shoulders and forward head posture narrow the thoracic outlet. Anatomical: cervical rib (extra rib from C7), scalene muscle hypertrophy. Trauma: clavicle fracture malunion. Repetitive overhead activity: overhead athletes, hairdressers, certain industrial workers.
Physiotherapy Treatment
Postural Correction
Addressing the rounded-shoulder forward-head posture that narrows the thoracic outlet: thoracic extension exercises, scapular retraction and depression, deep cervical flexor training.
Scalene Stretching
The anterior and middle scalene muscles, when hypertonic or hypertrophied, compress the brachial plexus. Specific scalene stretching provides significant symptom relief.
Neural Mobilisation
Brachial plexus mobilisation (upper limb tension tests used therapeutically) improves nerve gliding through the thoracic outlet.
TOS Treatment in Faridabad
At Realign Rehab Clinic, NIT-5, Faridabad, we provide expert assessment and management of thoracic outlet syndrome. Book your assessment today.