Hand Therapy blog post
Thoracic Outlet Syndrome (TOS)
Thoracic Outlet Syndrome, commonly referred to as TOS, is among the most challenging and controversial diagnoses in the upper limb. This blog aims to summarise this condition and explore how hand & upper limb OT and Physios care for patients presenting with potential symptoms of TOS. What is happening in the body The thoracic outlet is a region comprising three spaces located between the neck and upper arm. This area houses several important structures, including nerves (Brachial PlexusO arteries and veins. Compression typically occurs in one of three spaces. The spaces are named according to neighbouring anatomical structures. The structures are called; Inter-scalene triangle, Costo-clavicular space and the Sub-coracoid space. Prolonged adoption of certain body postures, muscle thickening, overuse, and other factors affecting the surrounding muscles can contribute to compression of these nerves and vessels. Types of Thoracic Outlet Syndrome TOS is broadly classified into three main types, each presenting unique symptoms; 1. Neurogenic TOS- when the Brachial Plexus (nerves) is compressed. 2. Vascular TOS- from compression of the Subclavian artery and/or vein. 3. Non-specific TOS- cases where tests cannot definitively identify the cause of symptoms. Common Causes and Movements Certain movements, postures, and conditions may increase the likelihood of developing TOS, including:
Symptoms Symptoms of TOS vary depending on the type:
Diagnostic Approach Diagnosing TOS is complex. We will start with a comprehensive history of symptoms and then conduct a couple of provocative tests. Other diagnostic tools include getting an; X-ray, MRI, CT scan, ultrasound or angiogram. Management Options Management of TOS operative or non-operative.
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Author Jo MarshClick here to edit Archives
February 2025
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Adelaide & Hills HAND THERAPY. Hand & arm rehabilitation in Adelaide and the Adelaide Hills SA.