04/11/2025
Thoracic Outlet Syndrome (TOS)
occurs when the nerves or blood vessels between the clavicle bone and the first rib are compressed, leading to:
pain
- numbness
Weakness in the neck, shoulder, and arm.
Signs and symptoms:
• Neurogenic TOS (Nerve compression):
• Pain in neck, shoulder, and arm.
• Numbness and tingling in hand (especially ring and pinky fingers).
• Weak grip strength.
Venous TOS (Vein compression):
• Arm swelling.
• Bluish discoloration.
• Heaviness in the arm.
Arterial TOS (Artery compression):
• Cold hands or fingers.
• Pale or discolored hand.
• Weak pulse in the arm.
Special tests used for diagnosis:
* Adson's test: Assesses changes in the radial pulse with neck movements.
* Roos test: Checks for numbness, tingling, or pain with arm elevation.
(physical therapy management)
1. Pain management: Manual therapy, ice/heat.
2. Postural correction: Strengthen scapular and neck muscles.
3. Nerve gliding exercises: Improve nerve mobility.
4. Stretching: Scalene and pectoral muscle stretches.
5. Strengthening: Rotator cuff and shoulder girdle muscles.
6. Breathing exercises: Diaphragmatic breathing.
7. Functional training: Gradual return to daily or sport activities
Doctor of physical therapy
