Now more than ever before, adults are being diagnosed with a condition called thoracic outlet syndrome (TOS). Once considered rare, this painful condition of the upper body is affecting both adults who work in physically demanding jobs and adults who sit at their jobs for long periods of time.
Thoracic outlet syndrome happens when the blood vessels and nerves between your collarbone and first rib become compressed. The nerves most commonly affected include the radial, ulnar, median, and musculoskeletal nerves. When these nerves are compressed, it can create an incredibly painful and tingling sensation felt anywhere in the neck, chest, shoulders, and arms, depending on the nerves affected.
Who Is at Risk for TOS?
The people most often diagnosed with TOS are athletes and manual laborers who use their arms and hands in repetitive ways, such as weight-lifters, jackhammer operators, and dental hygienists.
Thoracic outlet syndrome is also more common in pregnancy when the ribs and organs become compressed in the third trimester.
Desk jobs also contribute to TOS diagnoses, because the majority of people who sit for long periods of time develop poor posture, which leads to muscle tightness in the upper body.
Types of TOS
There are three main types of thoracic outlet syndrome, and they are: neurogenic, venous, and arterial.
- Neurogenic. This type of TOS affects the nerves and usually presents with pain, weakness, and loss of muscle at the base of the thumb.
- Venous. This type affects the veins and usually results in swelling, pain, and bluish discoloration of the arm.
- Arterial. This type of TOS affects an artery, and it presents in pain, coldness, and paleness of the arm.
Thoracic Outlet Syndrome Symptoms
Blood vessel and nerve compression are no joke. TOS can be extremely painful, and in severe conditions, it can lead to long-term damage in the arms, hands, and fingers. If you’re suffering from any of the following symptoms, it’s time to go get checked out by a doctor.
- Shoulder pain/aching/tingling
- Neck pain
- General upper-body pain
- Numbness in the shoulder, neck, chest, arm, hands, or fingers
- Cold fingers
- Weak upper extremities
- Flushed sensations in the upper extremities
- Discoloration in the upper extremities
Treatment for TOS
Once a person is diagnosed with thoracic outlet syndrome, he or she will most likely be referred to a physical therapist for an evaluation. The therapist will come up with a treatment plan and guide the patient through certain exercises and stretches to relax the muscles pinching the nerves and blood vessels.
Meanwhile, the patients may be prescribed medications to improve symptoms, like muscle relaxants, or they will be instructed to take over-the-counter anti-inflammatory medications.
Exercises for Thoracic Outlet Syndrome
Exercises for TOS focus on stretching and relaxing the muscles that are putting pressure on nerves and blood vessels.
To stretch the neck muscles.
Look straight ahead and bend your right ear to your right shoulder. Hold for 20 to 30 seconds and repeat 3 times on each side.
To stretch the pectoral muscles.
In a seated or standing position, bring your hands behind your back, palm to palm, and clasp them together. Try to squeeze your palms together as you push your hands downward and your chest out and up. Hold for 30 seconds and repeat 3 times.
Standing straight with your arms by your side, squeeze your shoulder blades together and hold for 5 seconds. Do 2 sets of 15.
To stretch the ulnar nerve.
Make the “okay” hand sign by touching the tips of your index finger and your thumb to create a circle. Bring your palm to your face as you turn your hand upside down. The circle created by your fingers should be around your eye, and your remaining three fingers should extend downward from your eye to your jaw. Your bent elbow will be high up in the air at the height of your head.
To stretch the radial nerve.
Extend your arm out so that it is parallel to the floor. Flex at the wrist, bringing your palm toward your arm, and press the back of your hand against a wall. At the same time, lean your head away from the extended arm, creating a stretch from the neck all the way through the arm.
To stretch the median nerve.
Perform the same exercise as the radial nerve stretch, but with your wrist flexed so that your palm is against the wall instead of the back of your hand.
For better posture.
Roll up a towel and place it on your bed or on an exercise mat on the floor. Lie down on the towel so that it is directly down the length of the spine, pushing your shoulders and shoulder blades back and your chest out.
Thoracic outlet syndrome can be extremely painful and debilitating. That’s why it’s crucial to perform stretches and exercises every day to prevent TOS in the first place. Daily stretches that target the upper-body muscles will help to keep them relaxed and flexible so that you don’t have to endure the pain that accompanies nerve compression.
If you do experience any of the symptoms mentioned above, make an appointment to see your doctor as soon as possible.