Thoracic Outlet Syndrome

Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is a complex and often misunderstood condition that involves the compression of nerves and blood vessels in the thoracic outlet—a narrow space between the scalene muscles in the neck and the first rib or the first rib and the collarbone. This can lead to a range of symptoms affecting the neck, shoulders, arms, and hands. Vascular surgeons at UTHealth Houston provide diagnostic and advanced therapy or surgical solutions to provide relief to those affected by TOS.   

Causes and Risk Factors

  • Anatomical Variations: Some individuals may be born with an extra cervical rib or other abnormalities of the cervical spine, making them more susceptible to nerve and blood vessel compression.
  • Poor Posture: Slouching or maintaining an incorrect posture can contribute to compression of the thoracic outlet structures.
  • Repetitive Movements: Jobs or activities that involve repetitive motions, such as typing or lifting heavy objects, can strain the muscles and increase the risk of TOS.
  • Trauma: Injuries such as fractures, dislocations, or muscle strains around the thoracic outlet area can trigger TOS symptoms.
  • Muscle Imbalance: Muscular imbalances in the neck and shoulder region can lead to compression of nerves and blood vessels.

Signs and Symptoms

The symptoms of TOS can vary, and individuals may experience a combination of the following:

  • Pain: Persistent pain in the neck, shoulders, arms, or hands, often described as aching, burning, or tingling sensations.
  • Numbness and Tingling: Numbness, tingling, or a “pins and needles” sensation in the fingers or hand.
  • Weakness: Weakness in the affected arm or hand, making it challenging to perform everyday tasks.
  • Coldness or Color Changes: Coldness, discoloration, or swelling in the hand or fingers due to compromised blood flow.
  • Muscle Atrophy: Muscle wasting in severe cases, leading to noticeable changes in the affected arm’s appearance.


Our team is committed improving your quality of life with early intervention and a tailored treatment plan to help you manage the symptoms of TOS. Diagnosing TOS often involves a combination of medical history, physical examination, and diagnostic tests. Treatment options depend on the severity of the condition and may include:

  • Physical Therapy: Stretching and strengthening exercises can help improve posture and alleviate symptoms.
  • Medications: Over-the-counter pain relievers, anti-inflammatory drugs, or muscle relaxants may be recommended to manage pain and discomfort.
  • Lifestyle Modifications: Ergonomic adjustments and avoiding activities that exacerbate symptoms can help prevent further aggravation.
  • Surgery: In severe cases where conservative treatments are ineffective, surgery may be considered to relieve nerve or blood vessel compression.
  • Nerve Blocks: Injection of numbing medication or corticosteroids into the affected area can provide temporary pain relief and may aid in making the diagnosis of thoracic outlet syndrome.

Preventing TOS involves maintaining good posture, practicing ergonomic habits, and incorporating regular exercises to strengthen the muscles of the neck, shoulders, and upper back. If you experience persistent pain, numbness, or weakness in your neck, shoulders, arms, or hands, call us today.

Meet the Physicians

Taylor D. Hicks, MD

Taylor D. Hicks, MD

UT Physicians Cardiothoracic & Vascular
Surgery – Katy

23920 Katy Fwy, Ste 400
Katy, TX 77494-0882

UT Physicians Cardiothoracic & Vascular
Surgery – Sugar Land

17520 West Grand Pkwy S, Ste 280
Sugar Land, TX 77479-4758
Naveed U. Saqib

Naveed U. Saqib, MD

UT Physicians Cardiothoracic & Vascular
Surgery II – Southeast

11914 Astoria Blvd, Ste 280
Houston, TX 77089-6048

UT Physicians Cardiothoracic & Vascular
Surgery – Lake Jackson

504 This Way St, Ste C
Lake Jackson, TX 77566-5155