People with TOS often are under the misconception of having herniated a disc or carpal tunnel syndrome.  Although many symptoms are the same, the two conditions are quite different. TOS usually manifests bilaterally, but unilateral incidences may also occur.   The patient presents with diffuse arm symptoms, including numbness and tingling.  The path is described as going down the inside of the arm  to the little and ring fingers.  This is often made worse by overhead activity.

This condition is caused by compression of the brachial plexus ( nerves that exit the cervical spine and join to travel down the arm), or of the subclavian/axillary arteries.  This compression is due to :

Elongated C7 transverse process

Cervical rib

Scalene mucles tightness

costoclavicular area diminution

Subcoracoid area diminution (between the coracoid process and pectoralis minor)

Muscular compression at the scalenes or pecs is due to tight muscles and/or  posturally induced (forward head and rounded shoulders).  This has become very common today, thanks to the extensive use of computers and hand held devices.

We can determine if the patient is suffering from TOS and not another condition by performing a series of very specific orthopedic tests.  Management is usually conservative, with an approach based on postural correction.  Stretching of tightened muscles and strengthening of weakened muscles.   Active Release Techniques is used to treat muscular adhesions, scar tissue build up and trigger points.  Chiropractic adjustment of the first rib is used to reduce the amount of  compression on the brachial plexus and subclavian/axillary arteries and alleviate symptoms.