Thoracic Outlet Syndrome (TOS) refers to conditions caused by the squeezing, injury, or irritation of nerves and blood vessels in the lower neck and upper chest. Named after the area located between your lower neck and upper chest, known as the thoracic outlet, TOS can affect anyone regardless of age or gender.
Types of Thoracic Outlet Syndrome
Neurological Thoracic Outlet Syndrome: This type of TOS is the most usual. It happens when the brachial plexus—a bundle of nerves running from the spine, through the neck, to the arm—gets squeezed. It often affects those who do repetitive arm motions above their head at work or play sports like swimming or baseball.
Venous Thoracic Outlet Syndrome: Thoracic Outlet Syndrome (TOS) occurs when the subclavian vein—a crucial vessel transporting blood from the arms to the heart—is compressed. Often due to congenital narrow pathway from the shoulder to the heart, TOS is worsened by repetitive arm and shoulder movements. These shrink the tight thoracic outlet space, increasing pressure on the vein and exacerbating TOS.
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Arterial Thoracic Outlet Syndrome: This condition, TOS, occurs when the subclavian artery—responsible for moving blood from the heart to the arm—gets blocked by a blood clot. It often affects people born with an additional rib in the neck or an irregularly shaped first rib, which can compress the artery and permanently narrow it.
Causes of Thoracic Outlet Syndrome
TOS-related problems can be confusing, but we know they happen when the thoracic outlet's narrow space squeezes blood vessels or nerves too much, leading to irritation and TOS. Also, certain conditions, characteristics, or behaviors could increase your chances of getting TOS. These are called risk factors.
Unchangeable Risk Factors: You cannot alter these factors. Having more increases your TOS risk.
~ Pregnancy
Risk Factors You Can Change: These are the factors you can manage or improve with treatment, medication, or changes in your way of life.
1. Intense weightlifting.
2. Bad posture.
3. Sports with repeated arm/shoulder use.
4. Heavy loads on shoulders.
5. Depression.
Other conditions that contribute to the development of TOS:
1. Birth defects in body structure.
2. Abnormalities in bone and soft tissue.
3. Injury-related trauma.
4. Upper chest or underarm tumors or swollen lymph nodes.
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Kanwal Bhardwaj
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Meet Kanwal Bhardwaj, PT, M.Sc.PT, CIMT, CMNT, the driving force behind Stride Physical Therapy in Freehold, NJ. With over 20 years of dedicated experience in the field, Kanwal brings a wealth of expertise and a passion for holistic healing to his practice. Kanwal's journey began with a Master of Science in Orthopedic Physical Therapy from Quinnipiac University in 2004. Over the years, he honed his skills and gained invaluable insights during 18 years of service in outpatient physical therapy offices. In 2014, fueled by a desire to deepen his understanding of patient care, he pursued a manual therapy certification (CIMT). This transformative experience allowed him to adopt a whole-body perspective, focusing on treating the root cause rather than just the symptoms...
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