Thoracic Outlet Syndrome: Symptoms, Causes & Treatment

pain while sitting at desk computerThis article features one of our clients, PhysioDC, a physical therapy rehabilitation clinic located in the heart of Washington, D.C. Visit them online at or call them at (202) 223-8500.

“Thoracic outlet” is the name for the area where vital nerves and arteries flow from the neck to the arm. Because so many structures exist in that area, there’s a high potential for the nerves to be pinched or otherwise disrupted in the thoracic outlet; such issues are lumped together and described as “thoracic outlet syndrome.”


As a result of the wide variety of potential causes, symptoms of this condition vary greatly. While some patients complain of sensations of coldness, others describe a shooting pain, and still others experience general weakness in their shoulder or arm. Most notably, some patients are left unable to hold their arms in particular positions for very long.

nervous systemCauses

A common contributing factor is related to posture. Sitting for extended periods of time, as many people with desk jobs do, can lead to the tightening of muscles at the front of the body. This issue is particularly common when a forward focus, such as on a computer screen, is a normal part of a person’s job. An example of this is when the pectoralis minor muscle keeps the shoulders rolled forward in an unhealthy, slouching position. That muscle crosses over nerve bundles, so their overuse can cause thoracic outlet syndrome.

Another example would be the scalene muscles, which are located on the sides of the neck. When those muscles become stiff or tight, restriction of nerves is the natural result. Those same scalene muscles can also suffer from weakened back muscles that result from sitting at a computer for long time periods.

A third possible cause of thoracic outlet syndrome includes shifting of the ribcage and clavicle. Like the other causes, this one is the direct result of postural dysfunction. Because the shoulder blade is attached to the clavicle with ligaments, the forward rolling of the shoulder blade causes the clavicle to change positions, as well.


physical therapy for back injury

For thoracic outlet syndrome caused by problematic posture, there are a few key ways you can respond in order to alleviate your discomfort as well as prevent future problems. First, an ergonomic evaluation of your workspace should be conducted. While an in-person evaluation is ideal, online consultations can be effective, as well. From lighting to monitor height, mouse placement to keyboard position, the many variables of your working environment could be the clear cause of your chronic discomfort.

In addition to an ergonomic evaluation, personal visits with healthcare professionals can help you strengthen weakened muscles. Those muscles often affected due to postural dysfunction include the deep flexors of the neck (longus colli), the external rotators of the shoulder, the lower and upper trapezium, and the serratus anterior. For those with forward posture, the key will be to stretch the anterior structures, especially those in the chest. By lying on a rolled towel or foam roll, you can allow gravity to help stretch your shoulders, reversing the effects of sitting at a desk for hours on end. Ideally, such stretching is preparation for a back-strengthening exercise regimen.

PhysioDC of Washington, D.C.

Daniel Baumstark and his professional team of physical therapists operate a boutique physical therapy office in downtown Washington, D.C. From athletes to government officials, and from ballerinas to corporate executives, PhysioDC helps people recover, strengthen and return to healthy living. Visit their website at or call them at 202-223-8500.

Image credits: Top by Josep M Suria/Fotolia; Middle by Sebastian Kaulitzki/Fotolia; Bottom by Innovated Captures/Fotolia

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