Nerve flossing is a great way to soothe TOS and regain your range of motion, especially with traditional physical therapy. However, to ensure your symptoms don’t worsen, get a diagnosis from your doctor.
Thoracic outlet syndrome (TOS) is when the collar bone, neck, and rib at the top of the outlet compress blood vessels or nerves.
The condition causes neck and shoulder pain and numbness in your fingers, affecting sleep.
Some common causes of TOS include repetitive injury from sports-related injuries or a job, car accidents, physical trauma, anatomical defects such as having an extra rib, and pregnancy.
TOS treatment usually involves pain relief measures and physical therapy, and in some, surgery.
Who is affected by thoracic outlet syndrome?
TOS affects people of all gender and age.
However, the condition is common among people who participate in sports involving the repetitive activity of the arm and shoulders, such as baseball, swimming, and other sports.
Causes of thoracic outlet syndrome?
The following are the leading causes of TOS:
- Depression or stress
- Participating in sports involving the repetitive activity of the arm and shoulders, such as baseball, swimming, volleyball, and others
- Injuries from carrying heavy shoulder loads
- Damage to the back or neck
- Large lymph nodes or tumors in the underarm area or upper chest
- Sleep disorders
3 types of thoracic outlet syndrome
There are three types of TOS which include:
It occurs when one or more veins under the clavicle (collarbone) become compressed, causing upper-body thrombosis. Only 5% of cases are venous.
Arterial thoracic outlet syndrome is a less common type of syndrome.
It occurs when an artery becomes compressed, causing it to bulge. The condition is also known as an aneurysm.
Neurogenic TOS is the most common type of thoracic outlet syndrome, which occurs when the nerves from the arm, the brachial plexus, and the neck become compressed.
At least 90% of the cases are neurogenic.
A combination of the three TOS is possible when multiple parts of the thoracic outlets become compressed.
Symptoms of thoracic outlet syndrome
Thoracic outlet syndrome symptoms depend on the type of TOS.
Symptoms of neurogenic thoracic outlet syndrome
- Aches or pains in your shoulder, arm, neck, or hand
- Arms that tire quickly
- Tingling or numbness in your fingers
These symptoms may come and go but worsen when arms are raised.
Symptoms of venous thoracic outlet syndrome
- Swelling of the fingers, hand, and arm
- Painful tingling in the arm and hand
- Throbbing lump near your collarbone
- Blood clots in the veins of your upper body
- The blueness of the arm and hand
Symptoms of arterial thoracic outlet syndrome
- Pale and cold hands or fingers
- Aneurysm of the subclavian artery
- Blocked artery in the arm or hand
- Pain in the arm and hand, especially during overhead motion of the arm
- Weak or no pulse in the arm
Diagnosis of thoracic outlet syndrome
The most crucial step in TOS is making a proper diagnosis. A vascular or chest surgeon can treat this condition.
A doctor may use Most or all of the following to begin a TOS evaluation:
- History evaluation to rule out any nerve-related conditions such as cervical spine disease, cubital tunnel syndrome, or other types of nerve disorders
- Physical movements to provoke symptoms
- Review of symptoms and complete medical history
- Chest X-rays to check for abnormal first rib or cervical rib
- Blood tests
Is thoracic outlet syndrome serious?
Although many cases of TOS are unavoidable, the condition is treatable. Some of the TOS complications include:
- Blood clot
- Neurogenic complications
- Permanent arm pain and swelling
- Death of body tissues caused by the low flow of blood
Treatments for thoracic outlet syndrome
Early detection of TOS can help improve its treatment. Thoracic outlet syndrome treatment depends on the type of TOS you have.
The treatment’s goals are to relieve pain and symptoms. Your healthcare provider will advise you on the best treatment option.
Neurogenic thoracic outlet syndrome treatment
- Typically the first treatment is physical therapy. It increases the range of emotions in the shoulder and the neck strengthening the muscles and promoting better posture. Most patients experience an improvement in symptoms after this.
- A doctor may recommend pain relief medication such as aspirin and ibuprofen. They can also suggest a muscle reluctance for additional pain relief.
- Surgery, in some cases, can be done if symptoms persist despite medication and physical relief to cut small muscles in the neck and remove the first or cervical rib.
Venous thoracic outlet syndrome treatment
Surgery is usually done for venous TOS to remove the subclavius and scalene muscles.
Since blood clots form around the damaged inner surface of the compressed vein, you must treat the vein.
Venous TOS treatments include:
- Thrombolytic medications used to dissolve blood clots
- A post-rib resection venogram is performed two or three weeks after surgery to check for any damage to the vein.
Arterial thoracic outlet syndrome treatment
Patients with aerial TOS often require surgery. It involves removing both the cervical rib and the scalene muscles.
Other treatments are:
- Blood thinners to treat blood clots.
- Replacement or reconstruction of the arteries if they contain clots or aneurysm
Coping strategies for sleeping with thoracic outlet syndrome
Good sleep is vital to feeling refreshed and productive. However, people with thoracic outlet syndrome lack quality sleep due to the discomfort that comes with it.
Depending on your activities during the day, your TOS condition may worsen at night.
Sleeping postures affect the quality of sleep. Good sleeping postures ensure that the lower back is aligned with the upper body and the cervical spine.
The natural spine looks like the letter “S” from the side. This allows proper weight distribution in the body.
It also enables a range of motions and flexibility. Poor alignment can lead to back aches, balance issues, fatigue, and neck aches.
TOS symptoms may worsen with poor sleeping positions.
Consider your arm position while sleeping. For example, if you sleep on your stomach with your arms on either side of your head, you are compressing the brachial plexus for about eight hours.
The right pillow also makes a difference. Thoracic outlet syndrome patients find relief when they place a pad under their elbows to lift them to shoulder levels.
Make sure your shoulder muscles are not resting on the pillow, as this can lead to spine misalignment.
Tips for improving sleep quality with thoracic outlet syndrome
The following tips can help you improve your sleep quality if you have TOS:
Have a bedtime and waking routine
This routine is critical to getting good sleep. It allows your body to form a habit that supports the sleep cycle, hence falling asleep faster and longer.
This routine is also helpful for waking up in the morning!
Waking up at the same time each morning helps you adapt to the sleep cycle allowing you to get the most sleep possible hence becoming more focused.
Analyze your sleeping environment
The right sleeping environment can make sleeping easier. Prepare your room by ensuring it is in order with proper light and temperatures.
Sleep in comfortable nightwear
Ensure your nightwear is not tight, as this can increase pressure on the collarbone and worsen pain or discomfort caused by TOS.
Be active during the day
Take walks, spend time outdoors, and do exercises. All this will improve your sleep quality at night.
What is thoracic outlet syndrome?
Thoracic outlet syndrome, TOS, is a disorder that occurs when nerves or the blood vessels in the thoracic outlet become compressed.
What are the three types of TOS?
The three types of thoracic outlet syndrome include:
– Neurogenic TOS
– Arterial TOS
– Venous TOS
Can thoracic outlet syndrome be fatal?
If untreated, TOS can cause severe life-threatening conditions such as pulmonary embolism and blood clots.
Is heat better for thoracic outlet syndrome?
Applying heat to the thoracic outlet may relieve muscle and nerve compression that can lead to pain and swelling.
Can you massage thoracic outlet syndrome?
Massage therapy is the best treatment plan for TOS. Direct massage relieves the tension in the muscles caused by compression.