Thoracic Outlet Syndrome Treatment
Numbness, tingling, or a heavy, achy feeling down the arm can trace back to a tight, crowded space near your collarbone. Thoracic outlet syndrome responds well to physical therapy that opens up that space and takes pressure off the nerves and vessels running through it.
What causes thoracic outlet syndrome?
The thoracic outlet is a narrow passage near the collarbone and first rib where nerves and blood vessels travel from the neck into the arm. When the muscles or bones around that space tighten or crowd it, they can compress those structures, producing the numbness, tingling, and ache that define this condition.
The muscles at the base of the neck and across the chest form part of the thoracic outlet's walls. When they become tight or overdeveloped, from posture, stress, or specific training patterns, they narrow the space and put direct pressure on the nerves and blood vessels passing through.
A slumped, forward shoulder posture closes down the thoracic outlet space further, especially when combined with a forward head position. This is one of the most common and most correctable contributors to ongoing symptoms.
Jobs or sports that involve frequent overhead reaching or arm elevation repeatedly narrow the thoracic outlet space with each rep, gradually irritating the nerves and vessels that pass through it.
An old collarbone fracture, whiplash, or shoulder injury can leave scar tissue or altered muscle patterns that permanently narrow the thoracic outlet, causing symptoms that may not appear until months or years after the original injury.
A small percentage of people are born with an extra cervical rib or a different first-rib shape that narrows the thoracic outlet from birth. While this can't be changed with therapy, the muscular and postural factors around it usually can be, which often resolves symptoms even when the anatomy is a contributing factor.
How physical therapy in Portland helps.
Physical therapy for thoracic outlet syndrome focuses on opening up the space where the nerves and vessels are being compressed. We use manual therapy to release tight scalene and pectoral muscles and improve the mobility of the first rib and collarbone, combined with postural retraining that keeps the space open throughout your day. We also build strength in the muscles that support good shoulder and neck alignment, since posture is what determines whether the improvement holds. Most cases of thoracic outlet syndrome improve significantly with this conservative approach before any more invasive treatment is ever considered.
What to expect from your recovery.
Evaluation
We assess your posture, neck and shoulder mobility, and perform specific tests to confirm where the compression is occurring and what's contributing to it.
Releasing compression
We use manual therapy to release tight scalene and pectoral muscles and improve mobility around the collarbone and first rib, taking pressure off the compressed nerves and vessels.
Postural strength and prevention
We build the postural strength that keeps the thoracic outlet open long-term, so numbness, tingling, and arm heaviness don't return once you're back to full activity.
I worked closely with both Ryan and Sue during my PT journey. They were absolutely wonderful to work with. They helped remedy my injury through prescribing helpful exercises, habits, and also sharing a ton of knowledge.
Pain rarely travels alone.
Neck Pain
Thoracic outlet syndrome and neck pain often share the same tight scalene muscles, so we treat both together.
Elbow, Wrist & Hand Pain
Nerve compression near the collarbone can cause symptoms that travel all the way down to the hand.
Shoulder Pain
Shoulder posture and mechanics directly affect the thoracic outlet space, so we evaluate the shoulder as part of your care.
Ready when you are.
Saturday - Sunday: Closed