At AB Myotherapy, clients come to us with a variety of symptoms from muscular pain to neurological symptoms. Thoracic outlet syndrome (TOS) is a relatively common group of conditions caused by the compression or irritation of blood vessels and nerves that run through the space between your clavicle and first rib, called your thoracic outlet, to serve your arms. It is often aggravated by elevation of arms above the head.

TOS can be separated into three mains categories, depending on whether the compression is affecting the nerves, arteries or veins.

Neurogenic thoracic outlet syndrome:
This relates to the nerves that provide motor and sensory function for the arm and hand. This is the most common presentation of TOS and some of the symptoms include pain down the arm, paraesthesia (abnormal sensation either tingling or pins and needles), arm or hand weakness and a loss of dexterity.

Venous and Arterial thoracic outlet syndrome:
As the names suggest, these types of TOS deal with compression of blood vessels. Symptoms can include pain in affected arm, swelling  and signs of poor circulation such as blue tinged skin, cooler hand or arm and decreased pulse.

The causes for TOS can be as varied as the symptoms, but it is essentially caused by a narrowing, or change in shape of the thoracic outlet. This can be the result of many different factors, including but not limited to; bony anomalies such as an addition cervical rib, or an enlarged first rib; bone remodelling after fractures of the clavicle or first rib; and muscular compression by muscles in the neck and shoulder girdle. Poor posture and repetitive overuse commonly have an impact on this presentation.

How Myotherapy can help?
Myotherapy treatment for TOS would include a thorough history of the presenting complaint, perform an assessment including posture, movement, strength, special tests and palpation, then design and discuss a treatment plan. The aim of treatment wold be to treat the muscle imbalances associated with TOS improve the symptoms of nerve compression and to allow the nerves to work in an optimal capacity. Management would include improving upper body posture by implementing strength exercises, changing movement patterns, sleeping position or recreational activities. Co-management of TOS is also fundamental to recovery. A Myotherapist can work alongside other allied health or medical practitioners to help manage thoracic outlet syndrome.