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Thoracic Outlet Syndrome

Definition, Symptoms and Possible Causes


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Definition of TOS

The thoracic outlet gets its name from the space (the thoracic outlet) between your your first rib and your collarbone (clavicle). This tight passageway is filled with blood vessels, muscles, and nerves. Thoracic outlet syndrome (TOS) refers to the abnormal compression or irritation of these vessels, nerves and muscles in this area. Click here for a good diagram of the thoracic outlet and surrounding area.

Symptoms of Thoracic Outlet Syndrome

The medically established symptoms of TOS may include:

  • Numbness, swelling or tingling of the arm, shoulder and hand

  • Pins and needles feeling down the arm

  • A "heavy feeling" in the arm

  • Tingling feeling in the hands, especially the pinkie finger and the one next to it

  • Coldness in the hand and arm due to decreased blood circulation

  • The arm and hand may swell up and the blood vessels may appear more pronounced and "bulgy"

  • woman holding a sore neck   Shoulder and neck pain

  • Restrictive movement of the neck arm and shoulder

  • Bluish discoloration of the arm and hand due to decreased blood / oxygen flow.

My Personal Saga

Listed above are the conditions medical doctors often link to TOS. Listed below are symptoms, based on my personal experience, I believe are often overlooked symptoms of TOS. Because TOS involves pressure on the nerves, muscles and the blood vessel to the head, eye and nose, I suspect there are more facial conditions caused by TOS than are often diagnosed by most doctors. In my case, and I suspect others, TOS caused a domino effect of imbalances on the whole left side of my head. And in turn I think I had some overall body alignment issues which caused the TOS.

For years I went to opthamologists and optometrists for eye floaters and pain in my left eye, but they never found anything wrong. It wasn't until I was diagnosed with thoracic outlet syndrome and found a physical therapist who was able to treat the condition that I understood the cause of my eye problems. My physical therapist explained to me that my TOS was putting pressure on the nerves around my head and neck as well as restricting blood flow to my eye and nose on my left side. This pressure is what caused my eye to hemorrhage and my nose to bleed just on one side. Eventually, I was able to clear up many of the following conditions with physical therapy, trigger point therapy and yoga poses designed especially for TOS.

The conditions I experienced along with my TOS included:

  • Eye floaters

  • Wavy lines in my peripheral vision. (I've found I can bring this condition on inadvertently when I do yoga poses that tighten my shoulder muscles too much, and I can get rid of the wavy lines with yoga poses that looses up my shoulders and relieve pressure on my eye.)

  • Flashes or "seeing stars"

  • High blood pressure just on one side on my body

  • A feeling of pressure behind the eye on the TOS side

  • Eye pain

  • Eye hemorrhage (bleeding in the eye)*

  • Nose bleeds* just from one side of the nose

  • Headaches just on left side of my head

  • Shoulder popping out of place (my left shoulder muscles were so tight at one point that once my shoulder joint popped out of place just from brushing my teeth.)

I'm also much more nearsighted in my left eye than in my right. I suspect it may be at least in part from the TOS restricting blood flow, and the nutrients that blood carries, to that eye.

Established Causes

  • Excessive exercise that can cause tightening and shortening of the shoulder and neck muscles

  • An extra rib

  • A higher first rib or raised shoulder due to a postural or structural defect linked to scoliosis, kyphosis (rounded shoulders), a sunken chest (pectus excavatum), or a barrel chest (pectus carinatum).

  • Fibromyalgia

  • outline of a person slouching showing poor posture
      Poor posture

  • Whiplash, car accidents, related trauma

  • Repetitive strain injuries from computer usage, playing musical instruments, and any other activity with repetitive motion causing tight muscles to press on the thoracic outlet

  • Any combination of the above events. Click here for more possible causes.

In my own experience my TOS was most likely mainly caused caused by my scoliosis. My spinal curvature caused my left shoulder to be higher than my right. However, saying my TOS was caused by my scoliosis is a somewhat oversimplified, short answer. The long answer is that in turn my scoliosis was caused by a combination of tight muscles, weak bone structure and poor posture which in turn were probably caused by a combination of genetic factors and a very nutritionally poor, sugar laden diet as a child.

Continue to => Part 2





Related sections of interest:

Natural Treatments for Fibromyalgia

My Personal Causes of Neck Pain

Thoracic Outlet Syndrome Defined

What Causes TMJ?

Finding a Good Physical Therapist


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