From Tingling Hands to Full Recovery: Understanding and Treating Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) occurs when nerves or blood vessels are compressed in the space between the collarbone and the first rib. This area—called the thoracic outlet—houses the brachial plexus and major blood vessels, and compression here can lead to a range of symptoms. While TOS can be complex, the good news is that many cases respond well to conservative care before surgery is considered.

Causes of Thoracic Outlet Syndrome

• Anatomical variations: Cervical ribs, bony overgrowths, or hypertrophied scalene muscles can narrow the thoracic outlet.
• Postural factors: Forward head posture, rounded shoulders, and repetitive overhead use are common contributors.
• Trauma or repetitive strain: Car accidents, repetitive lifting, or sports injuries can inflame or irritate tissues in the area.

Symptoms

Neurogenic TOS (most common): Numbness or tingling in the arm or fingers, neck and shoulder aching, grip weakness, and fatigue with arm use.

Vascular TOS: Color changes in the hand, swelling, cold sensation, or even blood clot formation, depending on whether veins or arteries are affected.

New Research on TOS

Recent studies confirm that structured physical therapy can significantly improve symptoms of neurogenic TOS. In one study, 25 out of 42 patients experienced meaningful improvement after six months of targeted therapy. The STOPNTOS randomized trial found that while surgery may help certain non-responders, conservative care remains the best first-line approach.

How We Address TOS at MVMT STL

Our approach combines hands-on care, acupuncture, and targeted rehabilitation to reduce compression, restore function, and improve long-term movement.

• Manual Therapy & Active Release (ART): Targeting scalene, pectoral, trapezius, and levator muscles to relieve tension and free up nerve and vessel pathways.
• Acupuncture: Reduces muscle tension and enhances local circulation, especially effective alongside manual therapy.
• Rehabilitation: Stretching tight muscles, strengthening scapular stabilizers, correcting posture, and performing nerve gliding exercises to restore optimal mobility.
• Lifestyle Modifications: Educating patients on activity changes—such as reducing heavy shoulder loads—to prevent flare-ups.

The Bottom Line

Thoracic Outlet Syndrome is highly individual, but with the right assessment and a conservative treatment plan, many patients can avoid surgery and return to an active, pain-free life. At MVMT STL, we focus on restoring balance, posture, and movement to keep you doing the things you love.