Definition:

'Thoracic outlet syndrome' ('TOS') is a syndrome involving compression at the superior thoracic outlet Common orthopaedic tests used are the Adson's sign, the Costoclavicular_maneuver, and the "Hands-Up" test or "EAST" test. Careful examination and radiograph are required to differential diagnosis between the positional and static aetiologies, first rib fixations, Scalene muscles spasm, and a cervical rib or fibrous band.

Symptoms:

• Pain- sharp, burning, or aching
• Pain in the arm, hand that includes all or some fingers, neck, pectoral area, axilla, and upper back
• Decoloration of the hands
• One hand colder than the other hand
• Weakness of the hand and arm muscles
• Tingling

Causes:

• Faulty posture
• Abnormalities, enlargement, or spasm of the various muscles surrounding the arteries, veins, and/or brachial plexus
• Fixation of a first rib, or a cervical rib
• Pancoast tumor
• Physical trauma from a car accident
• Repetitive strain injury

Treatment:

• ROM and stretching
• Posture program
• Soft tissue massage
• Shoulder stabilization exercises
• Upper extremity strengthening