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The Different Types of Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is a condition that occurs when nerves and blood vessels in the neck and shoulder are compressed or squeezed as they exit the thoracic outlet, a narrow passageway between the collarbone and first rib. This can cause a variety of symptoms, including pain, weakness, and numbness in the affected area.

There are three types of TOS, each with its own set of symptoms and causes:

  1. Neurogenic TOS: This type of TOS occurs when the nerves that control the arms and hands are compressed. Symptoms include pain, weakness, and numbness in the arms and hands, as well as tingling and a "pins and needles" sensation.

  2. Venous TOS: Venous TOS occurs when the veins that carry blood from the arms and hands to the heart are compressed. Symptoms include swelling, discoloration, and a feeling of heaviness in the affected arm.

  3. Arterial TOS: Arterial TOS occurs when the arteries that carry blood to the arms and hands are compressed. Symptoms include coldness, paleness, and a weak or absent pulse in the affected arm.

TOS can be caused by a variety of factors, including trauma, repetitive strain, and anatomical abnormalities. People who engage in activities that require repetitive motions or who have poor posture may be at higher risk for developing TOS. Yes, you sitting hunched over your computer all day! SIT UP TALL. It is also common after something like a car accident or whiplash.


Treatment for TOS depends on the type and severity of the condition. Non-surgical treatments include physical or occupational therapy, massage, and medications to relieve pain and inflammation. In more severe cases, surgery may be necessary to relieve the compression on the affected nerves or blood vessels.


With neurogenic TOS therapy is almost always the first line of treatment. A therapist can asses to figure out where your nerves are being pinched and give you a program to help get them "unstuck". This will include exercises for your shoulders and back to help improve your posture. Stretching to help open your chest can also give those nerves more space to travel. The doorway stretch is a MUST! (download our free exercise guide!) Hands on manual work with joint mobs, stretching and massage can help to ensure everything is able to move the way it should! Sometimes that collarbone can become stuck with TOS and therefore doesn't roll out of the way and pinches the nerves, a therapist can help move and glide that collarbone to help your body re-learn what it should be doing!


If you are experiencing symptoms of TOS, it is important to seek medical attention promptly. A doctor can diagnose the condition and recommend appropriate treatment to alleviate your symptoms and prevent further damage to the affected nerves and blood vessels. A therapist can also complete special testing to give you insight to the diagnosis and determine if this may be something your suffering from.


Thoracic Outlet Syndrome is a condition that affects the nerves and blood vessels in the neck and shoulder region. It can cause a variety of symptoms, including pain, weakness, and numbness in your whole arm, and can be caused by a variety of factors. If you are experiencing symptoms of TOS, it is important to seek medical attention promptly to ensure the best possible outcome and help you to STOP LIVING IN PAIN.

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