Thoracic outlet syndrome

Thoracic outlet syndrome (TOS) is a disorder that involves the compression of a nerve bundle (brachial plexus) and associated blood vessels as they travel through or near to the narrow space between the collarbone (clavicle) and the first rib known as the “thoracic outlet”.  Compression at or near the thoracic outlet can be caused by pressure from bones, ligaments or other soft tissues on the nerve bundle and/or blood vessels. 

Thoracic outlet syndrome is actually identified as three different syndromes.

1.  Neurological Thoracic Outlet Syndrome

This is the most common category of thoracic outlet syndrome and is characterized by impingement and irritation of the nerves of the brachial plexus.  The brachial plexus is the nerve bundle that travels from the cervical spine (neck) to the arms where it supplies the arms and hands with motor and sensory function. 

2.  Vascular Thoracic Outlet Syndrome

This type of thoracic outlet syndrome is brought on when veins and/or arteries traveling through or near to the thoracic outlet become compressed and blood circulation to the arm is inhibited.

3.  Non-Specific Type of Thoracic Outlet

Also known as “disputed thoracic outlet syndrome”, is indicated when there is unexplained arm, posterior (back of the) shoulder or neck area pain.  Symptoms usually begin after a trauma such as a motor vehicle accident.


Symptoms of Thoracic Outlet Syndrome

Symptoms are most often those of nerve irritation and include:

  • Pain, particularly in the inner aspect of the arm, forearm, and the ring and small fingers.
  • Numbness and/or pain often at night, in many cases it is severe enough to cause sleep disturbances.  
  • The numbness and/or pain often involves all 5 fingers but usually it is most noticeable in the ring and small finger and on the small finger side of the forearm.
  • Weakness of the neck, chest and arms .
  • Cold intolerance to the affected area.
  • Neck pain, pain over the upper trapezium, anterior chest wall pain, and base of the skull headache may also occur.
  • Swelling of the arm.


Causes of Thoracic Outlet Syndrome

Repetitive strain

Repeatedly performing the same task(s) such as typing, lifting objects overhead or performing athletic movements like pitching can put one at risk of compressing the nerves and or vessels traveling through the thoracic outlet.

Poor Posture

Slumping posture with shoulders rolled or head held forward could cause compression in thoracic outlet.


A traumatic event like a ski crash that has lead to a collarbone break can also be a cause of thoracic outlet syndrome.



In Traditional Chinese Medicine all three types of thoracic outlet syndrome are considered a blockage syndrome, due to the blockage of the blood vessels and motor and sensory nerves of the arm and hand.  Treatment approach for thoracic outlet syndrome involves an assessment followed by a combination of Traditional Acupuncture, manual therapy such as massage, herbal supplementation and stretching techniques.


For any question or to book an appointment please contact my office at (250) 860 -2212 or visit my website www.kelownaacupunctureclinic.com 

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.

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About the Author

Ryan Samuels is a Registered Acupuncturist and Chinese Medical Herbalist (R.Ac, R.TCMP) at KLO Chiropractic Centre in Kelowna. He holds a Doctor of Traditional Chinese Medicine diploma, and has a special interest in the treatment of digestive issues, neuropathy, acute & chronic pain, sports injuries, and migraines.  All treatments with Ryan are individualized and designed around your current physical and mental well being. 

Website link:  http://www.kelownaacupunctureclinic.com/

Contact Email:  [email protected] 

The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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