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Physical Therapy for Thoracic Outlet Syndrome – Information, Exercises, and More

Thoracic outlet syndrome can make your life difficult.

Between the pain, the numbness and tingling, and the discoloration in your arms and hands, TOS (thoracic outlet syndrome) can be overwhelming.

Luckily, thoracic outlet syndrome is also treatable. You don’t have to live with your symptoms forever.

This guide will show you how physical therapy exercises for thoracic outlet syndrome can reduce your symptoms and improve your quality of life.

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome is described as compression of the nerves, veins, or arteries in the neck and chest area.

The nerves, veins, or arteries in your neck get squeezed, and that pressure causes the symptoms you may be experiencing.

The term is used to describe any of its three associated disorders:

  • Neurogenic thoracic outlet syndrome (compression of the nerves)
  • Venous thoracic outlet syndrome (compression of the veins)
  • Arterial thoracic outlet syndrome (compression of the arteries)

Symptoms can vary based on the part that is suffering from compression.

Over 90% of all TOS patients have Neurogenic TOS. Venous TOS makes up less than 6% of patients. Arterial TOS is the least common, by far, affecting only 1% of patients.

What Causes Thoracic Outlet Syndrome?

Thoracic outlet syndrome can affect just about anyone.

You could experience TOS if you:

  • Are leaned over a computer or desk all day.
  • Have been in an auto accident.
  • Make repetitive movements with your arms.
  • Have an anatomical abnormality

There are several potential causes of thoracic outlet syndrome, but the outlook is good, no matter the cause.

Physical Injury or Trauma

Being in an auto accident is traumatic enough, but when you are injured, it can be life-altering.

Many cases of thoracic outlet syndrome occur when the patient has experienced whiplash as a result of an auto accident.

Patients with a physical injury, such as whiplash, or those who have suffered physical trauma may not experience the symptoms of TOS right away.

Repetitive Movement

Doing the same thing over and over can wear you down.

The same is true for your body. 

Repetitive motions that can cause this wear and tear include:

  • Typing
  • Swimming
  • Throwing a baseball (such as pitching)
  • Stocking shelves or scanning groceries
  • Working on an assembly line

Thoracic outlet syndrome can occur in cases where the patient frequently makes these repetitive movements.  

Any type of repetitive motion that causes you to raise your arms over your head or move your hands with your arms in a position that can limit circulation poses a risk for developing TOS.

Poor Posture

If you sit at a desk all day, you know that it can be a real pain in the neck. Literally.

Improper alignment of the head, neck, back, and hips due to poor posture can create both circulation and nerve compression. This may lead to thoracic outlet syndrome in some patients.

Anatomical Abnormality

Some people are born with an extra rib, called a cervical rib. 

This anomaly can mean there is compression from overcrowding.

In most cases, the pressure placed on nerves by a cervical rib can still be treated without surgery.

Thoracic Outlet Syndrome Symptoms

Every patient is different and will experience thoracic outlet syndrome symptoms in different ways.

Your symptoms can vary, depending on which type of TOS you are dealing with.

Some of the most common symptoms include:

  • Paresthesia in extremities (numbness or tingling in your hands and arms)
  • Pain and weakness
  • Occipital headaches

These symptoms can range from mild to severe. 

Being aware of the symptoms and sensations you are experiencing can help with proper diagnosis and treatment.

Paresthesia in Extremities

If you’ve ever experienced a “pins and needles” feeling, you’ve felt paresthesia.

Paresthesia can occur when pressure is placed on your nerves for an extended time.

In thoracic outlet syndrome, this compression can lead to a numbness or tingling feeling in the arm and hands.

The sensation is not permanent and can be significantly improved, and even eliminated, with proper treatment.

Pain and Weakness

Any time there is compression on the nerves, veins, or arteries, you can experience pain.

Thoracic outlet syndrome can restrict your movement, making it difficult or painful to move your arm or turn our head.

Pain in the back of the head, neck, and shoulders are reported most by TOS patients.

Occipital Headaches

The occipital nerves run from the neck up the back of the head and behind the ear.

When you have a headache caused by pain from those nerves, it is called occipital neuralgia.

Occipital headaches due to thoracic outlet syndrome may last for hours and can be debilitating.

Thoracic Outlet Syndrome Treatment

In cases of Neurogenic thoracic outlet syndrome, many doctors recommend conservative treatment options first. 

These treatment options are non-invasive and do not require recovery time, unlike surgery.

Treatment options for thoracic outlet syndrome include:

  • Exercise
  • Physical Therapy
  • NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
  • Surgery


For milder cases of TOS, doctors might recommend exercises to improve posture and strengthen the chest muscles.

Exercises that safely target the chest muscles, when done correctly, may relieve the symptoms of thoracic outlet syndrome.

When the muscles are stronger, less pressure is put on the neck and shoulder.

Strengthening the chest and core muscles can also help to improve posture.

Physical Therapy

Possibly the most common treatment for thoracic outlet syndrome is physical therapy.

Licensed physical therapists, like the ones at In Motion, O.C., may help you regain your range of motion and reduce pain.

Physical therapy offers you a variety of treatment options to find relief from your specific TOS symptoms.

Here are just a few approaches to TOS that may be used by your licensed physical therapist:

  • Electrical stimulation
  • Stretching exercises
  • Targeted heat therapy (such as therapeutic ultrasound)
  • Posture correction 


Over-the-counter pain relief medication, specifically nonsteroidal anti-inflammatory drugs (NSAIDs), are often recommended.

These medications can help reduce swelling and inflammation, as well as relieve minor pain and discomfort.


In cases of genetic abnormalities (such as the presence of a cervical rib) or when physical therapy is not enough, some doctors recommend surgery.

The type of surgery your doctor will recommend depends on which type of thoracic outlet syndrome has been diagnosed.

Thoracic Outlet Syndrome Physical Therapy – Will PT Help?

Physical therapy can not only help with thoracic outlet syndrome; it is the most commonly prescribed treatment by many doctors.

Because a licensed physical therapist can make an individualized plan to alleviate your specific symptoms, PT offers you the chance to heal on your own terms with a treatment plan you agree with.

Best Thoracic Outlet Syndrome Exercises

In order to determine the best thoracic outlet syndrome physical therapy exercises for you, you’ll need to answer these questions:

  • What symptoms are most prevalent for you? 
  • Which type of thoracic outlet syndrome is affecting you? 
  • What led to your diagnosis of thoracic outlet syndrome?

Since not every case is the same, the best exercises will depend on your unique situation.

There are several commonly prescribed movements that can help relieve your symptoms.

Chest Strengthening

Strengthening the muscles of the chest can help relieve compression.

Correcting your posture by building muscle can aid in reducing pain, discomfort, and help prevent future occurrences.

Neck Stretches

Neck stretches are commonly recommended for patients with TOS.

A great way to stretch your neck, even if you don’t have thoracic outlet syndrome, is to roll up a towel and place it on the floor behind your neck.

Gently nod your head up and down, allowing the towel to both support and stretch the neck.

This is a great exercise if you spend all day looking down at a screen.

Shoulder Stretches

Since much of the neuralgia and pain can be in the shoulder, stretching those muscles can feel great.

One example is to stand with your back straight and arms at 90-degree angles, hands pointing out.

Gently squeeze the shoulder blades together, opening the chest to do so.

This stretch can relieve tension in your shoulders and chest.

How In Motion O.C. Can Help With Thoracic Outlet Syndrome

One of the worst feelings in the world is to feel like you can’t function as you should. Whether you are experiencing pain, swelling, numbness, or tingling, you deserve to find relief.

And you don’t have to take the road to recovery alone.

You can be one of the thousands of patients helped by the caring staff at In Motion O.C. and find out why we are the number one rated physical therapy provider in the country on Yelp.

You just want to experience a life without pain and suffering. Let us get you there.

*This information about physical therapy for Thoracic Outlet Syndrome was reviewed by Dr Natalie Thomas, PT, DPT. If you have any questions, please don’t hesitate to contact us here.

In Motion O.C.