Thoracic Outlet Syndrome
Thoracic Outlet Syndrome (TOS) is compression of the nerves and arteries that supply the arm. As they climb over the first rib and under the collar bone, they have to squeeze between the muscles that run between the ribs and the neck. If these muscles are tight, or the first rib is stuck in a ‘bucket handle up’ position, or the clavicle is pulled down by altered postures of the shoulder, then the nerves and arteries to the arm can become compressed, and create a ‘dead’ arm. Rarely, TOS can be caused by the presence of a tumour in the upper lung, by the presence of an extra rib, or due to the postural changes associated with pregnancy.
Treatment of Thoracic Outlet Syndrome
After identifying the cause, the aim of treatment is to reduce the pressure on the nerves as soon as possible, by restoring normal motion patterns to the shoulder, reducing the muscle tone in the neck muscles, ‘resetting’ the position of the first ribs, or by reducing any other small compressions on the nerve, such as Carpal Tunnel Syndrome.