Recently at Range of Motion Physical Therapy Lucan, I had a client attend the clinic with what is commonly know as Thoracic Outlet Syndrome (TOS).

The clients symptoms caused them to wake in the middle of the night with numb hands and pins & needles, they described it like sleeping on their arm. The numbness was only present at night and had been ongoing for 2 weeks with no relief.

The client had no history of neck pain or recent injury to neck or shoulders. During history taking the client explained they had recently changed jobs that involved more manual lifting and carrying, with long shifts and long commutes to work by car.

On physical examination there was no pain in neck or shoulder movements, I observed slight restriction in neck movements and very tight neck muscles. Also their posture was not great with rounded shoulders and forward head posture. I was able to recreate the numbness sensation in the arms and hands by compressing down on their collar bone and also having them do a Roos Test.

So what is TOS!

Thoracic outlet syndrome is a group of disorders that occur when the blood vessels or nerves in the thoracic outlet — the space between your collarbone and your first rib — become compressed. This compression can cause pain in your shoulders and neck and numbness in your fingers/hand.

Common causes of thoracic outlet syndrome include physical trauma, repetitive injuries from work, such as my client – or sports-related activities. There can also be certain anatomical defects, such as having an extra rib, and pregnancy.

Treatment for thoracic outlet syndrome usually firstly involves physical therapy and pain relief measures. With this client I worked on the tight neck muscles and gave home stretches and educated them on their posture. Following the 2nd treatment I reassessed the client and they reported no numbness into their hands.

In addition to the treatment the client also said using a warm hot water bottle around the tight neck muscles helped relief the numbness.

Please contact me should you wish to discuss this issue or any further issues.