Have you ever experienced tingling or numbness in your hand or arm? Maybe you suspected you had carpal tunnel syndrome, but that could be the wrong diagnosis. We often find that patients with carpal tunnel symptoms actually have thoracic outlet syndrome (TOS). It's a common self-misdiagnosis. 

Patients with TOS can experience a range of symptoms that limit their ability to carry out everyday activities. Simple tasks like grasping, typing or using a mouse become challenging and frustrating. Even overhead lifting can be difficult. TOS can cause a major disruption to your daily life, including decreased productivity that sets you back. Luckily, chiropractic can help. 

What is Thoracic Outlet Syndrome?

TOS is caused when a tight muscle, habitual posture, or cervical rib puts pressure on the blood vessels and nerves traveling down your arm. These blood vessels and nerves become compressed in the space between your collar bone and your first rib, causing:

• Neck pain
• Arm pain
• Numbness/tingling

These symptoms may travel into your ring and pinky finger.

What does Thoracic Outlet Syndrome feel like?

Patients with TOS can feel arm pain and numbness or tingling that gets worse with overhead arm movements. They may also feel cold and clammy sensations in their affected forearm, hand and/or fingers.

What causes Thoracic Outlet Syndrome? 

TOS can be caused by a variety of factors, most notably:

• Trauma, which accounts for 40% of TOS cases
• Poor posture, such as rounded or slumped shoulders and "text neck"
• Tight neck and/or chest muscles
• The presence of cervical ribs, a unique finding in approximately 1% of the population

We find that this condition is common with desk workers, given the posture they assume during the day.

We’ve seen the effects of the rare cervical rib in our office.

Dr. Goldi had a patient with TOS years ago. This patient was a young mother who found her symptoms worsened when she held her children.  She also worked as a nurse, and had difficulty bending over her patients. 

Dr. Goldi suspected that the patient had a cervical rib and referred her for X-rays. The patient was not a candidate for surgery at that time, and was treated with chiropractic care off and on for a few years, with successful results. 

Several years later, she suffered a traumatic injury while wakeboarding, causing her symptoms to return. Her arm was violently yanked during a fall, and she eventually had surgery to remove the cervical rib. Since the surgery, she has been asymptomatic.

How does chiropractic work for Thoracic Outlet Syndrome?

Chiropractic has been shown to be a successful treatment protocol, backed by scientific evidence:

In 2015, the Journal of Manipulative and Physiological Therapeutics (JMPT) published a study that assessed how chiropractic care affected patients with TOS. The study looked at spinal adjustments, mobilizations, soft tissue therapies and exercises. 28 patients with TOS received chiropractic treatments for 12 weeks. The results showed significant improvements in pain, disability and quality of life.

How do chiropractors diagnose Thoracic Outlet Syndrome?

We attempt to produce arm symptoms by recording how strong, forceful, or full your pulse is while in different arm and head positions. If we see reproduced symptoms, or we feel your pulse intensity diminish, then we know you have TOS.

How do chiropractors treat Thoracic Outlet Syndrome?

At our clinic, we focus on adjustments of your lower cervical and upper thoracic spine, including the first and second ribs. This has been shown to be effective in reducing your pain and discomfort. 

We may also offer trigger point therapy to address any tight muscles that may be compressing your affected vessels and nerves.

If we suspect the presence of a cervical rib, we may send you for X-rays and refer you to an orthopedic specialist for further evaluation. Sometimes, the cervical rib may need to be removed if conservative care doesn't lead to significant relief. 

How long does it take for chiropractic to work for Thoracic Outlet Syndrome?

You could experience some relief from TOS symptoms after a few chiropractic sessions. It can also take several weeks—or even months—of regular treatment to fully resolve the condition, especially if it has been present for an extended period of time.

What self-care is recommended for Thoracic Outlet Syndrome?

There are quite a few actions you can take to prevent and ease your TOS symptoms:

• Stretch your pectorals (chest muscles) and scalenes (neck muscles) regularly to prevent tightness that can contribute to TOS symptoms
• Strengthen your rhomboids (shoulder blade muscles), and middle and lower trapezius (back muscles) to improve posture and decrease strain on the neck and shoulders
• Use taping and bracing to help maintain good posture and alignment throughout the day
• Pay attention to your posture while working, driving and using electronic devices to avoid slouching or hunching forward

Experiencing arm pain, numbness and/or tingling?

Your symptoms may be due to Thoracic Outlet Syndrome. We can help you figure out the cause and develop the right treatment plan. Schedule an appointment online with our experienced chiropractors at our Aptos clinic. We can help ease your pain and get you back into life.