A large amount of nerves and blood vessels supply the arm and travel from the neck and down a few narrow channels, through the shoulder and down into the arm and hand. These channels can sometimes become narrower, resulting in compression of those nerves and blood vessels. This can cause different symptoms, ranging from mild tingling and numbness to poor circulation throughout the arm affecting the hands and fingers. This is what’s known as Thoracic outlet syndrome (TOS). There are two primary types of compression:
#1 Costoclavicular which is the result of the space between the collar bone and first rib becoming narrower.
#2 Compression by the scalenes, three small muscles within the side of the neck, which can occur as tension builds in the area.
While Thoracic Outlet Syndrome (TOS) can be caused by sudden trauma, it’s more often caused by repetitive actions and postures. Those who have jobs or habits that require movement of the arm up and forward repeatedly are more likely to develop TOS, experiencing the tell-tale symptoms of pain, tingling, numbness, weakness, swelling, and coldness in the shoulder, arm, hand, and fingers. Treatments vary depending on the area and intensity. Most clients will be prescribed physical therapy, anti-inflammatory medications, and in severe cases where these less invasive treatments aren’t successful or severe damage is imminent, surgery may be necessary to take the pressure off the nerves and blood vessels.
Massage therapy is an excellent addition to treatment plans for TOS. The compression caused by the Scalenes can be decreased by relieving those muscles of tension through direct massage of the upper shoulders, neck, upper chest, and jaw. If the compression is costoclavicular, massage can often help to increase the space between the collar bone and the first rib. Along with stretching and some strategic mobilisations, mild cases of TOS can often be handled well by a knowledgeable massage therapist. You may also notice that I will massage throughout the entire neck, shoulders, back, and arms to alleviate any associated tension, decrease problematic holding patterns, and treat contributing issues within those areas.
It’s important to remember to communicate throughout the session. I would need to know if certain movements or pressure in specific areas, either relieves your symptoms or makes them worse, as I treat. With that information, I make adjustments for your comfort (I never want you to be in pain during treatment), it also provides important clues as to how to best treat your specific type of Thoracic Outlet Syndrome. If you’re experiencing symptoms of TOS, or already have a diagnosis, ask your doctor if massage therapy might be a beneficial addition to your treatment plan.