Have you been experiencing numbness or tingling in both hands when you raising your arms over your head, when you’re washing or drying your hair, or perhaps during prolonged cleaning or overhead activities? It could be the symptoms of a condition known as thoracic outlet syndrome. It is not nearly as common a condition as tennis elbow or carpal tunnel syndrome.

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome or TOS involves the compression or pinching of a bundle of nerves and blood vessels located at the base of the neck and in the shoulder. Compression often happens because of a congenital or an injury or change in the bones or soft tissues around this area.

Possible causes of Thoracic Outlet Syndrome

In 1% of the population and 10% of cases of TOS, there is the presence of an extra rib above the others that compresses this bundle. Poor posture such as having the head and shoulders forward can also be a contributing factor.

TOS can also appear as a result of a shoulder injury (ex: motor vehicle accident) or repetitive overhead activity. The symptoms can be quite vast and it can sometimes be hard to diagnose.

Overhead activities can be a possible contributing factor of Thoracic Outlet Syndrome

Common Symptoms

  • Paresthesia (pins and needles or numbness in the fingers and/or hands)
  • Feeling of weakness and heaviness in arm
  • Cramp-like pain in arm and hand
  • Changes in the colour of the hand
  • Hands feel cold
  • Dull ache or pain in the neck, shoulder or armpit
  • Wasting of the muscles in the hand at the base of the thumb (in chronic cases)

Symptoms can vary in terms of how often they occur, length of duration and the amount of compression present.

Treatment options

Now what can you do about it? First of all, the easiest thing that we can work on is maintaining good posture. Keep your head back and shoulders rolled slightly backward and downward. Instantly you will feel like you are standing more upright. This on its own can improve your symptoms greatly.

Having the head sitting more forward could lead to muscles tightening up.

Physiotherapy is also often recommended and can make a significant difference as they assist with:

  • Strengthening muscles of the shoulders
  • Correcting your posture
  • Obtaining better range of motion in your shoulder
  • Releasing tight muscles that could be compressing the nerves
  • Answering any questions or concerns you may have about TOS

A physiotherapist can treat this condition by:

  • Releasing the surrounding soft tissue (manually, with an instrument or a needle/acupuncture)
  • Mobilizing adjacent joints
  • Stretches for tight muscles and nerves
  • Education on the condition
  • Postural adaptions
  • How to adapt your daily activities to avoid symptoms.

In some cases, it might be a good idea to ask your doctor about a nerve conduction study in order to see if any of the nervous pathways are affected by TOS.

Surgery can also be an option if the problem is longstanding and not responding to any treatment. A conservative treatment is always recommended before any type of drastic measure such as surgery.