Thoracic Outlet Syndrome (TOS)

The nerves and blood vessels that supply the arm run from the neck and through a few narrow channels that can sometimes become even more narrow, resulting in compression of those structures. This can cause a variety of symptoms, ranging from mild tingling and numbness to poor circulation throughout the arm and into the hand and fingers. This is what’s known as Thoracic outlet syndrome (TOS). There are two primary types of compression:

  • Costoclavicular is the result of the space between the collar bone and first rib becoming narrower.
  • Compression by the scalenes, 3 small muscles within the side of the neck, can occur as tension builds in the area.

While Thoracic Outlet Syndrome can be caused by sudden trauma, it’s more often caused by repetitive actions and postures. Those who have jobs or habits that require movement of the arm up and forward over and over again are more likely to develop TOS, experiencing the telltale symptoms of pain, tingling, numbness, weakness, swelling, and coldness in the shoulder, arm, hand, and fingers.

Treatments vary depending on the area and intensity. Most patients will be prescribed physical therapy, anti-inflammatory medications, and in severe cases where less invasive treatments aren’t successful, surgery may be necessary to take the pressure off the nerves and blood vessels.

Massage therapy is an excellent addition to most treatment plans for Thoracic Outlet Syndrome. The compression caused by the scalenes can be decreased by relieving those muscles of tension through direct massage. If the compression is costoclavicular, massage can also help to increase the space between the collar bone and the first rib. Along with stretching and some strategic mobilizations, mild cases of TOS can often be handled well by a knowledgeable massage therapist. You may also notice that we’ll massage throughout the entire neck, shoulders, back, and arms in order to alleviate any associated tension, decrease problematic holding patterns, and otherwise treat contributing issues within those areas.

It’s important to remember to communicate throughout the session with your massage therapist. We’ll need to know if certain movements or pressure in specific areas either relieves your symptoms or makes them worse as we go. That information is how we make adjustments for your comfort (we don’t want you to be in pain during treatment), and it also provides important clues as to how to best treat your specific type of TOS.

If you feel you have symptoms of TOS, we can perform simple orthopedic assessments to determine the proper treatment plan.

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