Apex Performance Centre

Thoracic Outlet Syndrome

Thoracic Outlet Syndrome

Do you have pain in your neck or shoulder with tingling or numbness in your forearm or hand? Thoracic Outlet Syndrome is a set of symptoms associated with compression or ischemia to the blood vessels or nerves in the thoracic outlet, which is the space between your collarbone and first rib.

Thoracic Outlet Syndrome


What Is Thoracic Outlet Syndrome?

Compression or lack of blood flow to the nerves will cause irritation to the nerve, leading to pain in the neck and shoulder and burning, tingling or numbness down the arm and into the hand.

The nerves are part of the brachial plexus and provide strength and sensation to the arm muscles. The nerves originate in the neck and emerge between the anterior and middle scalene muscles, before passing underneath the collarbone and pectoralis minor muscle, leading to the armpit.

Brachial Plexus

Structures Involved

The structures that are vulnerable to compression or ischemia (decreased blood flow) are the blood vessels and nerves of the brachial plexus.


The causes of thoracic outlet syndrome are diverse. It can be a structural anomaly, such as a cervical rib or a previously fractured sternum or clavicle. It can be caused by tight scalene muscles in the neck or tight pectoralis minor muscles as see in people with repetitive jobs or sports demands.

It is also common in pregnant women as the increased amount of fluids produced by the body can take up some of the room in the thoracic outlet.


The most common symptoms are neck and shoulder pain and tingling or numbness in the forearm and hand. These symptoms are often worse when working overhead.

Neck And Shoulder Pain


Prognosis depends on the initial cause of the symptoms and the duration of pain. If it’s a postural issue recovery is often quick. A structural issue such as a cervical rib will have less resolution of symptoms.

How Apex Can Help

Treatment is aimed at restoring blood flow to the nerves, as nerves use 20% of the body’s oxygen and need oxygen and nutrients to function optimally. Restoring blood flow is accomplished by stretching any tight muscles that constrict blood flow, correcting posture to reduce stresses on the nerves and flossing the nerve to ensure it can slide appropriately between tissues.

This will prevent impingement on the nerve. Acupuncture is one of the most effective ways of restoring blood flow as it as it goes below the skin to directly stimulate blood vessels.

Postural taping using Rocktape or Leuko tape can also help when poor posture is the cause. In the case of overworked neck muscles, Apex is unique in that we offer a biofeedback system to train the deep neck flexors and other postural stabilizers.

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