Thoracic Outlet Syndrome


Thoracic outlet syndrome is a condition that causes the compression of the nerves or blood vessels as they pass from the neck into the shoulder. This entrapment occurs as the neurovascular bundle travels between the scalene muscles of the neck and between your collar bone and first rib.

The incidence of thoracic outlet syndrome of the neurological variety is three times more common in women than it is in men. It is also the most commonly unrecognised cause of failed carpal tunnel surgery.

Causes of thoracic outlet syndrome:

  • Development of a cervical rib.
  • Trauma as from a car accident or a heavy tackle in football.
  • Repetitive trauma for work or sport.
  • Tightness or growth of the scalene muscles.
  • Pregnancy.


Signs and symptoms of thoracic outlet syndrome:

  • Neck, shoulder and arm pain.
  • Pins, needles and numbness into the arms and hands.
  • Symptoms are reproduced with the arm in an overhead position.
  • Signs of poor circulation in the hand or forearm (a bluish colour, cold hands, or a swollen arm).
  • Weakness of the muscles in the hand.


Physiotherapy treatments for thoracic outlet syndrome:

  • Rest from overhead activities.
  • Mobilisations of structures restricting the thoracic outlet.
  • Nerve gliding.
  • Postural education.
  • Strengthening of the stabilising back and neck muscles.
  • Surgery may be required in the case of a cervical rib.