I have tingling and pain that shoots from my shoulder to my hand whenever I grip or lift things. My doctor thinks I have thoracic outlet syndrome. Will I need surgery, or are there other ways to treat my problem?

Thoracic outlet syndrome (TOS) is a condition where the nerves or arteries that go to the arm and hand get squeezed between soft tissues near the side of the neck. With few exceptions, surgery is a last resort for treating TOS. Most people are able to get a handle on their TOS symptoms through a therapy program. Specialized exercises can improve muscle balance and posture to lessen your TOS symptoms. A physical or occupational therapist usually designs the exercise program. The therapist can also suggest ways to do your work with greater ease and fewer TOS symptoms. Work postures and tasks can contribute to symptoms of TOS.


I am an avid and lifelong swimmer. Recently, I have developed thoracic outlet syndrome (TOS). I have heard that swimming is good therapy. Is swimming OK for someone with TOS?

Thoracic outlet syndrome (TOS) is a condition where the nerves or arteries that go to the arm and hand get squeezed between soft tissues near the side of the neck. Swimming can be a helpful part of therapy for TOS patients who can tolerate it. However, you should avoid doing the full breaststroke and the backstroke. These strokes put extra pressure on the nerves and vessels near the thoracic outlet. When your symptoms are under control, you may choose to try these strokes again. But if your TOS symptoms start to come back, you should stop.


My doctor told me that I’ve got problems with thoracic outlet syndrome because I hunch over at my work bench all day. I assemble small electronic parts. My attempts to stay upright don’t last very long. Before I know it, I’m hunched over again. How can I keep from slouching at work?

Raise the height of the work bench slightly. This may make it easier for you to manipulate small items while you keep your back upright. Make sure you have adequate overhead lighting and an adjustable task light. Good lighting means that you won’t bend closer to see what you’re working on.


Be careful about resting your elbows on the bench. This can put cause pressure on the ulnar nerve, which runs along the inside edge of your elbow. Take breaks every 30 to 60 minutes to do some shoulder shrugs and stretching. Set up times to remind yourself to check you posture, such as when you check your watch or complete a routine task.


What is thoracic outlet syndrome?

Thoarcic outlet syndrome (TOS) is a condition in which pressure on nerves and arteries from the neck to the arm causes numbness in the arm or hand. TOS is difficult to diagnose. There are at least nine different spots where the nerves or arteries could be pinched, and there are no simple tests that confirm TOS. A doctor considers the medical history, the physical exam, and the results of diagnostic tests in making a diagnosis of TOS.


I’ve heard that thoracic outlet syndrome is caused by an extra cervical rib. Why won’t my doctor just remove the rib?

Thoracic outlet syndrome (TOS) involves pressure on the arteries or nerves running from the neck to the arm. TOS is rarely caused by an extra cervical rib. Surgery to remove the extra rib is only done when your doctor is absolutely sure it is causing the problem.


The pressure of TOS can start in at least nine different spots. It is often difficult to figure out exactly where your problem starts. That is why doctors usually recommend non-surgical treatment of TOS. You may work with a therapist to improve your posture, strength, and body mechanics to help ease the pressure. Stretching the muscles of the chest and shoulders can help. Swimming is a good exercise, as long as you avoid the backstroke and breaststroke. Non-surgical measures usually help as long as the muscles of your hand have not weakened and shrunk (atrophied) as a result of TOS.