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If you answer yes to any of the questions below, you might have Thoracic Outlet Syndrome.

  • Have you ever had your shoulder or arm give out on you while carrying something around?

  • Do you work on a computer, look at your phone, or use your arms all day long?

  • Have you ever felt tingly pain going down the arm anytime you reach your arm up?

What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome or TOS for short, is a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed.

In other words, anytime the nerves or blood vessels that come out of your spine and into your shoulder become compressed, it will be classified as Thoracic Outlet Syndrome.

What is the Thoracic Outlet?

The Thoracic Outlet is a pocket within the shoulder, just above the armpit, where a lot of important nerves and blood vessels come out of the spine. Thoracic = neck region.

Thoracic Outlet Syndrome Symptoms and Pain Pattern

TOS can be broken down into 2 different categories.

Thoracic Outlet Syndrome Neurogenic

This is classified when nerves are getting compressed within the Thoracic Outlet. Symptoms include.

  • Feel burning, tingling and numbing pain down the shoulder, arm, and even hands.

  • If a nerve becomes compressed, you may also feel weakness in your arm or hand.

thoracic outlet syndrome

Arterial / Venous Thoracic Outlet Syndrome

This is classified when arteries or veins are getting compressed within the Thoracic Outlet.

Symptoms include.

  • Discoloration in the hand or cold hands and fingers

  • Swelling and possible blood clots

  • Weak or no pulse the affected arm

  • Numbness or tingling in the fingers (similar to nerve pain)

9/10 people will most likely have neurogenic thoracic outlet syndrome vs venous thoracic outlet syndrome.

Thoracic Outlet Syndrome Pain Pattern

Pain from TOS can go from the neck all the way down to the hands and fingers. And I'm not talking about nervy or pain from the blood vessel; I'm talking about the pain from the muscles that are most likely causing your pain.

Causes of Thoracic Outlet Syndrome

There are many ways for the blood vessels and nerves to become compressed with the Thoracic Outlet.


The main cause of TOS will be overactive muscles. The reason why is because muscles are what control our movement and posture, and what you will see in a minute is how it relates to almost every reason for TOS.

Poor Posture

Poor posture can cause TOS because having your shoulders and head forward will create, almost like a pinch (aka compression) between the neck and shoulders. Good posture is created and formed by muscles having equal pull strength on their attachments.

For example. Proper bicep and triceps balance not only allows you to have full range of motion when flexing and extending the elbow, it also allows the bones and joint to sit in the proper place.

Poor posture is created when one muscle overpowers the other one. With the tricep/bicep example. If the bicep overpowered the tricep, then you would naturally walk around with a bent elbow. Not only doss this add stress to both muscles, it also adds stress to one specific side of your joints, leading to things like inflammation and even arthritis.

Repetitive Activities

Repetitive activities, like working on computers or stocking shelves, will lead to poor posture as well. Why? Just like how the body will adapt to get stronger after working out to save energy, the body will also adapt to our most common movement pattern to save energy.

This goes back to the posture situation above.

When you move into a specific position all the time, like sitting for example. Your body will recognize this and begin to make the muscles that are responsible for helping you sit more active. When this happens, you begin to have the same problems as I stated above in Poor Posture.


When it comes to trauma, I believe there are 2 types.

Hard injuries like car accidents - muscles being overactive have nothing to do with these kinds of traumas. Big shocker right?

Soft injuries, like stepping off a curve, could have been because of an overactive muscle. Here's how. When the body forms into a bad posture or performs repetitive activities, it will begin to resemble a worn-down house.

If you had 2 doors to your house but only used 1, then you would expect to repair one door faster right? The same goes here for your TOS; Just like how I talked about getting inflammation on one side of a joint because of excessive movement, what that also creates is weaker stability within that specific joint.

Now, your shoulders and arms are a lot more unstable in a specific position and can be damaged by simply picking up a book, aka a soft injury. It's more common to see people hurt themselves stepping off a curve which is another example of a soft injury.

(I know that took a minute to get back to my point, but thanks for sticking with me haha.)

To learn about different treatments for thoracic outlet syndrome, including the best treatment in my biased opinion, then click on the button below.

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Thoracic Outlet Syndrome or TOS is a general diagnose of nerves or blood vessels getting compressed within the shoulder and neck area. This area in the body is known as the Thoracic Outlet. TOS feels like nervy pain and can cause loss or color in the hands due to lack of blood. TOS can be caused by poor posture, repetitive movements, and injuries.

To see if you are one of the 80% of people who can eliminate their own TOS at home, then click on this link right here. Yes, any of these words that are highlighted.

About the Author Adam

Adam is the owner of Train and Massage and has earned multiple certifications including Human Movement Specialist, Certified Massage Therapist, Certified Personal Trainer, Corrective Exercise Specialist, and More.

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