Thoracic outlet syndrome

Compression of nerves or blood vessels between the neck and shoulder.

Overview

Thoracic outlet syndrome occurs when the nerves or vessels passing between the collarbone and first rib are compressed. It can cause arm pain, tingling or heaviness, often provoked by overhead positions. Posture and nerve-focused rehab usually help.

Symptoms

  • Arm pain, tingling or numbness
  • Symptoms worse with overhead activity
  • Heaviness or fatigue in the arm
  • Sometimes coldness or colour changes in the hand

Causes

  • Postural and muscular factors around the shoulder girdle
  • An extra cervical rib or tight scalene muscles
  • Repetitive overhead activity

Treatment

  • Postural retraining and breathing mechanics
  • Nerve mobility and shoulder-girdle strengthening
  • Activity modification
  • Vascular or surgical review in rare severe cases