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Thoracic Outlet Syndrome (TOS) is a condition relating to the compression of structures including the brachial plexus (a bundle of nerves supplying the arm), a major artery and vein, through an anatomical area called your thoracic outlet. This area is located between your lower neck, collar bone and first rib. 

What are the signs & symptoms?

Compression of this area can cause many symptoms most commonly in the arm, hand, and neck. You could experience one of more of the following: 

  • Pain
  • Muscle weakness and wasting
  • Pins and needles
  • Numbness
  • Paleness of the skin
  • Temperature changes

This collection of symptoms can also closely mimic other more serious medical conditions, so it’s important that you seek expert advice without delay.  

What causes Thoracic Outlet Syndrome?

There are many reasons you can develop TOS. These can include:

  • Trauma (commonly sports or motor vehicle accidents – e.g. whiplash & fractured collar bones)
  • Repetitive movement (overuse injuries)
  • Anatomical variations – (having an extra rib in the neck)**

** Did you know- 1-2% of the population have an extra rib in their neck called a cervical rib. However, for most people it remains asymptomatic. 

How can physiotherapy help?

Physiotherapy is recommended as a conservative management strategy to reduce the symptoms of compression through the thoracic outlet. The Physio Clinic Physiotherapists will undertake a thorough assessment of your symptoms through a series of specific tests used to diagnose TOS. They will then devise an appropriate individualised treatment plan aimed at addressing your specific symptoms. 

What will treatment include?

Our physiotherapists can work with you to help manage and alleviate the symptoms associated with TOS through a combined approach of treatment techniques including:

  • Soft tissue release
  • Dry needling
  • Joint mobilisation
  • Postural advice
  • Education
  • Exercise therapy

At The Physio Clinic we offer both individualised 1:1 or group exercise sessions, focused on improving your strength and flexibility aimed at reducing your symptoms of Thoracic Outlet Syndrome.

For more information contact The Physio Clinic on 8342 1233 or click below to book online.


By Angela Zerella | Senior Physiotherapist / Marryatville Team Leader


Jones, M., Prabhakar, A., Viswanath, O., Uritis, I., et al, 2019, Thoracic Outlet Syndrome: A Comprehensive Review of Pathophysiology, Diagnosis, and Treatment, Pain Therapy, 5-18.