Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a group of conditions caused by compression or irritation of structures passing from the neck and upper chest into the arm—most commonly the brachial plexus nerves, and less often the subclavian vein or subclavian artery. Because the thoracic outlet is a tight anatomical space bordered by the collarbone, first rib, surrounding muscles, and connective tissue, symptoms can vary widely depending on what is being compressed. People may report neck and shoulder pain, arm heaviness, numbness, tingling, hand weakness, color changes, swelling, or symptoms that worsen with overhead activity or prolonged posture.

Treatment options vary because TOS is not one single disorder. Neurogenic TOS is the most common form and is often approached first with posture-focused rehabilitation and activity modification. Venous or arterial TOS may involve more urgent vascular evaluation, imaging, anticoagulation or clot-directed care, and sometimes surgery. There is also overlap with conditions such as carpal tunnel syndrome, cervical radiculopathy, and rotator cuff problems, which can complicate diagnosis. As with Gold Bamboo’s related content on nerve entrapment and posture-linked syndromes, a balanced review often includes both conventional strategies aimed at anatomy and function, and traditional approaches that may help with pain, muscle tension, and quality of life.