Neck pain caused by Thoracic Outlet Syndrome T.O.S.
16th March 2011
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Do you suffer from neck pains? Maybe this is why.

This month I am talking about Thoracic Outlet Syndrome (TOS). This is a condition, which causes pain in the arm in the shoulder, arm and neck. TOS is a term used to cover three types of TOS. Firstly, neurological TOS, which is a compression of the brachial plexus (nerves of the upper limb). Secondly, Vascular TOS is the compression of the Subclavian artery or vein and lastly nonspecific TOS is pain from an unexplained cause.

Blood vessels and nerves from the body and spine pass through a narrow space between the shoulder complex. As they pass between the clavicle (collarbone) and first rib, the small space can be compressed.

This compression of the blood vessels and nerves causes all cases of TOS. Compression can be caused by an abnormally tight band of muscle connecting the vertebra to the first rib, an overuse injury or previous injury to the area as well as the possibility of having an extra rib (above the first rib).

Signs and Symptoms:
These vary depending on the type. Neurological TOS can be associated with numbness in the hand and forearm, or dull aching pain in the neck, shoulder and armpit. A more severe sign is   Gilliatt-Sumner Hand, which is a severe wasting of the fleshy base of the thumb.
Vascular TOS can be charactorised by a weak or absent pulse in the affected arm, which may also be cool to touch. There may also be numbness, tingling, aching and heaviness in the arm.


Non-Specific TOS most prominently features a dull, aching pain in the neck, shoulder and armpit that gets worse with activity. Non-specific TOS is often triggered by a traumatic event such as a car accident.

Treatment usually begins with manual therapy to reduce tension in the area, this could be using soft tissue massage, or mobilizing the Cervical spine and first rib. An exercise programme to strengthen the chest muscles, restore normal posture and relieve compression by increasing the space that the nerves or blood vessels have to pass through.

For more information on this injury please contact Adam Dobson on 07827324789 or email

About the Author

Jeanie W

Member since: 27th July 2011

Hi, I have lived in or around Swindon for 37 years. My main interests are family and friends, horses, aviation and sport. I enjoy meeting new people, eating out and travel.

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