THORACIC OUTLET SYNDROME-Self Help Tips, Treatment and Prevention From Dr James Stoxen DC – BOOK – NINE/TEN CHAPTERS FREE


You are reading Preface – Introduction – The Sonny Burke Story

Thoracic Outlet Syndrome ICD-9 353.0
Tips For Better Health
Ask the doctor, Dr James Stoxen DC



by Dr James Stoxen DC

Table of Contents

The Sonny Burke Story

Chapter I      What is Thoracic Outlet Syndrome? (TOS)
Chapter II     Anatomy 
Chapter III    The TOS Controversy
Chapter IV    History, Cause, and Patient Presentations
Chapter V     Physical Examination Findings
Chapter VI    Diagnostic Tests 
Chapter VII   Standard of Care Approaches – Surgical and Non-Surgical 
Chapter VIII  Frequently Asked Questions 
Chapter IX    Case Histories of Patients 
Chapter X     The Human Spring Approach to Treatment and Prevention



Patients come from around the world for treatment for Thoracic Outlet Syndrome by Dr. James Stoxen DC at Team Doctors. The results are not predicated on visits with our approach. The results come with how many hours Dr Stoxen spends resetting the mechanism. For those of you from outside Chicago, we have accelerated treatment plans that allow you to be treated all day for several days in a row until the condition is resolved to MMI.


A note from Dr Stoxen….. 

“Thoracic outlet syndrome is one of the most commonly misdiagnosed, mistreated, under-treated conditions in medicine. Many of my patients come to me from around the world. They have commonly already been to many of the top specialists in a few branches of medicine and have tried many standard treatment approaches and yet are still suffering.  I have had some patients that have been to over 20 doctors before coming to Team Doctors. The reasons why these standard approaches fail and the keys to proper examination, treatment, and prevention are revealed in this complete article below.

This article gets over 6,000 views a month. Because of it’s importance, I am in the process of writing a book about thoracic outlet syndrome. When the book is complete this article will be removed from the site.  If you find this information invaluable print the article now and sign up for our newsletter so we can let you know when it’s released.”

Please feel free to ask any question you like and even share your experience in the comments section at the bottom.  I promise I will respond quickly and decisively.”

Dr. James Stoxen DC


The Sonny Burke Story:

Sonny Burke is a music legend. The Roselle native played piano for Smokey Robinson for 34 years.  As a top studio musician he played on over 200 record albums and 1000 musical assignments including the entire Saturday night fever album, Jackson 5, Dancin Machine, and other Grammy award-winning artists.

One day Sonny couldn’t play at all….he was completely numb and too weak play. He couldn’t even button his shirt.

“It had been going on for four years. I couldn’t even make a fist,” he said. “I went to five top doctors.  First they told me I had unlnar nerve entrapment. I had surgery for that and it did nothing. While I was recovering from the surgery the numbness and tingling started spreading across my entire left hand then went up my entire left arm.   A few weeks later my right hand started going numb.   I progressively lost grip strength which baffled all the top doctors I went to. Then they diagnosed me with diabetic neuropathy. They said nothing could be done about that.  I had to live with it.

Yet now the legendary pianist is back playing again. “I can’t believe it,” says Burke. “In three weeks my hand strength has gone from 2% to almost normal.”

I had given up hope for a cure for my numbness and severe weakness after seeing 5 top doctors who operated on me and did every test and treatment they knew including surgery.  They finally told me there was nothing that could be done so I had to retire from music.” 

“Then I was introduced to Dr Stoxen by a friend backstage at a Steely Dan Concert.”

Sonny Burke didn’t have ulnar nerve entrapment, he didn’t need surgery, and he didn’t have diabetic neuropathy.

His real problem was called Thoracic Outlet Syndrome (TOS).

“When he told me he had diabetic neuropathy I didn’t think I could help him. My only hope was that he was misdiagnosed. When he told me he watched TV in bed…then I knew it could be TOS,” said Dr. James Stoxen of Chicago. The expert lectures on the condition worldwide.

Burke would probably still be helpless….if Steely Dan hadn’t recently come to Chicago.

He worked that night backstage with the group (and over 200 other visiting top recording artists). At dinner Steely Dan’s bass player, Freddie Washington, saw how helpless his friend Burke had become, he brought Sonny backstage to meet Dr Stoxen.

“After a thorough exam, the diagnosis was obvious,” says the chiropractor. “This is one of the most common, and commonly misdiagnosed, conditions in America.”

And the biggest cause of the problem?

“By far,” says Stoxen, “it’s watching too much TV in bed, leaning back in the car while driving, poor posture and ergonomics at the computer, text messaging, and other hand held apparatus. In fact, this problem barely existed until all-night programming.”

The problem for Sonny was this.  While on tour for months at a time, his routine was to lay in bed for hours watching TV while propped up with a pillow waiting for the limo to come take him to the show.

“We don’t realize it but we keep our 8-10 pound head suspended from our neck by contracting neck muscles called the scalenes.  Those muscles run from the back of the head to the first and second rib.”

“The head weighs as much as a bowling ball,” says Stoxen. “Watch TV in bed, even with a pillow, and those muscles are constantly contracted for hours at a time. It’s similar to holding a ten pound weight at arm’s length. What happens? Your scalenes go into constant spasm, they fatigue and then they contract constantly in a spasm compressing the neck and the outlet which the nerves, arteries and veins pass through to the arm.”

The scalenes swell compressing the artery, vein and nerves as they pass through them, they lift the first rib up constantly which brings it closer to the collar bone and the chest muscles pull the shoulder and collar bone down too.

That combination of events compresses the nerves and vessels against the overlying collarbone, and causes the symptoms of TOS. Besides weakness, those symptoms can include tingling, neck pain, shoulder problems, and headaches.  When it’s really bad it can cause clot formation, loss of the limb, permanent disability or even death,  if the clot releases

Dr. Stoxen says, “unfortunately, most TOS patients are misdiagnosed and many receive unnecessary surgery.  “Like Mr. Burke they’re mistakenly told they have herniated disc with a pinched nerve, diabetic neuropathy, carpal tunnel syndrome, or just think the patient is psychologically effected.”

To treat Burke’s real problem, first Stoxen had him move his TV out of his bedroom and advised him to sit up straight at all times. Next he repositioned the structures surrounding the thoracic outlet with a combination of unique hands on procedures he has developed followed by a specially designed rehabilitation exercise program.

“It takes me several hours to completely rebuilt the area of his neck and shoulders surrounding the outlet by hand,” he says. “Gradually, (after about ten treatments) the blood flow returns to the arms and hands, the feeling came back and Sonny’s strength came back.”

Doctors and patients do not realize how much work is involved in reversing thoracic outlet.  Most cases take 10 – 35 hours of hard core deep tissue to clear this up.  It is analogous to unraveling a pile of frozen steak and entwined wires with your bare hands.

Many patients with Burke’s symptoms ultimately get surgery. In 22 years of practice I have not sent a single patient for neck surgery and I treat some tough cases.”

“If you’ve noticed those tingling or weakness of your hands since the conventions, don’t just allow yourself to get possible unnecessary surgery,” says Stoxen. “Your real problem may be treatable with these methods.


Do you have Thoracic Outlet Syndrome? You likely feel this pain in your neck, arm or hand. It’s often an electrical or throbbing feeling that travels down your arm and can make your hands weak. In this book you will find every thing you ever wanted to know about Thoracic Outlet Syndrome.



What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome, also called thoracic outlet disorder which is a group of symptoms such as arm and neck pain or under shoulder pain, caused by pressure against the bundle of nerves and/or the arteries and veins that originate at the spinal cord at the neck as they pass through the scalene muscles, over the first rib and under the pectoralis minor and clavicle (collar bone), or collar bone muscle.

The other diagnostic labels that have been used to describe thoracic outlet syndrome are: Cervical rib syndrome, scalenus anticus syndrome, costoclavicular syndrome, hyper abduction syndrome, pectoralis minor syndrome, brachiocephalic syndrome, nocturnal paresthetic brachialgia, fractured clavicle-rib syndrome, deep vein thrombosis (Paget-Schroetter syndrome), superior outlet syndrome, naffziger syndrome, subcoracoid pectoralis minor syndrome, first thoracic rib syndrome, costoclavicular compression syndrome and cervical rib and band syndrome.

Thoracic Outlet Syndrome or the diagnosis of Thoracic outlet syndrome is the name given to several similar problems that can include arm pain from the neck which involves compression of the nerves and blood vessels of the area where your neck attaches to your body — the lower neck / upper chest region. It can also entail a pinching off of an artery that runs underneath the clavicle (subclavian artery). This causes arm numbness, arm tingling, or your arm in pain and often times pain in the hands that is often mistaken for carpal tunnel syndrome.

Thoracic Outlet Syndrome (TOS) is not only difficult to diagnose, many physicians deny its very existence. The truth is that inside the medical community, Thoracic Outlet Syndrome (TOS) is not well understood, difficult to image, and carries a great deal of controversy and disagreement over how best to treat it. In this article I will explain diagnosing for thoracic outlet syndrome, testing for thoracic outlet syndrome, symptoms of thoracic outlet syndrome and treatment for thoracic outlet syndrome.

This is one reason why so many people who have been told they have thoracic outlet syndrome contact me, a thoracic outlet syndrome specialist. Many of you are getting thoracic outlet treatment yet are still experiencing thoracic outlet pain, headaches, achy hands, tingling in the fingers, shoulder pain, below neck pain, upper back pain, chest pain with arm pain, swelling in the hands and even loss of grip strength thinking thoracic outlet surgery is the only option.

Some patients have symptoms of nerve compression, which causes severe neck pain, repeated migraines, shoulder pain, and a sense of tiredness or heaviness in the arm caused by thoracic outlet syndrome. Other symptoms of thoracic outlet syndrome may include tenderness over the neck muscles or around the collarbone, pressure on these areas causing pain or tingling in the arm, pain in the shoulder or arm with neck movements, and tenderness in the armpit. Even odd sensations in the face or ringing in the ear or ear pain can be caused by thoracic outlet syndrome.

The nerves supply sensation and muscle power to the arms and the arteries and veins provide blood supply to the arm. The pressure against these structures is caused by tight swollen scalene muscles, in the neck, shoulder and chest muscles as well as an elevated first rib with a depressed collarbone. There are many areas nerve compression, for these arteries and nerves to get compressed.

That is why you need to know the thoracic outlet anatomy so you can differentiate between venous thoracic outlet, arterial thoracic outlet syndrome, (vascular thoracic outlet), cervical ribs thoracic outlet syndrome, carpal tunnel syndrome. Thoracic outlet brachial plexus compression (neurogenic thoracic outlet), pectoralis minor thoracic outlet syndrome, or maybe you have all of the above!


Watch above as Dr. James Stoxen DC gives the lecture presentation Thoracic Outlet Syndrome at the 12th Annual World Congress on Anti-aging Medicine Mandalay Bay Hotel and Casino, Las Vegas Nevada December 4, 2004

Next Chapter I, What is Thoracic Outlet Syndrome 

All of the keys to proper examination, treatment, and prevention of Thoracic Outlet Syndrome are found in the latest edition of “THE HUMAN SPRING BREAKTHROUGH SOLUTION TO THORACIC OUTLET SYNDROME”

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About Dr James Stoxen DC (282 Posts)

Dr. James Stoxen, D.C., owns and operates Team Doctors Treatment and Training Center. and Team Doctors Sports Medicine and Anti-aging Products. He has been the meet and team chiropractor at many national and world championships. He has been inducted into the prestigious National Hall of Fame, the Personal Trainers Hall of Fame and appointed to serve on the prestigious, Global Advisory Board of The International Sports Hall of Fame. He is also a member of the Advisory Board for the American Board of Anti-Aging Health Practitioners. Dr. Stoxen is a sought after speaker, internationally having organized and /or given over 1000 live presentations around the world.(full bio)

  • Masud Kabir Hero

    nice post. need a strong patience for reading this. but its helpful.

  • Dear Masud, Thank you for taking the time to read this article. This has been written to best educate patients and doctors how to approach thoracic outlet syndrome.

    As you can see it is not a teaser article but more like a book. For those who suffer with this condition they will tell you that it is often misdiagnosed by one, two, three, and some 15 or 20 different health care providers. Some patients have been to 20 doctors, therapists, guru healers, massage therapists etc with no results. Some get the surgery and they feel worse. I love tough cases and have not had any challenges resolving TOS conditions without surgery. The more complex the better for me. Bring me your worst case.

    For these patients this article provides the answers that allow them to make the right decisions that are life changers. Those readers dont mind taking more time to digest the material.

    Many patients who read the article have called from around the world flew into Chicago to visit me at Team Doctors and had their TOS resolved in a matter of days with our 8-12 hour/day round the clock treatments.

    Because of this I plan on adding to it.

    Thank you very much for your comments.

    Dr James Stoxen DC
    President, Team Doctors Treatment and Training Center of Champions

  • Sean Daniels

    Dr Stoxen, Thank you for such an extensive research and information available on thoracic outlet. I have a history of weight training and sports and in have suffered nerve tingling for years and referred pain from my scalenes in the areas around my scapula and arm and upper chest region. about 6 months ago i started having noticeable atrophy throughout these referred regions-particularly in my hands with pain that sharply originated in my palm of hand which is where it started to depress. I had to stop working out and was diagnosed with overuse injury and told to rest and then was told carpal tunnel and being sent for more tests. Being a nursing student and the emotional toll of watching my body fade away on both arms, hands and upper back, i delved into research, looking into my symptoms and i realised early on that i had thoracic outlet syndrome- my chiro agreed. But then throughout this process i have been laughed at by a neurologist who said it wasn’t TOS after a nerve study and been through several specialists. I have nearly lost my livelihood with this condition- i have missed so many days off work, i had to stop studying because i couldn’t type for too long. I’ve stopped being able to lift weights or put body pressure on my hands-it’s a depressing state. It feels like no one is listening to me while my body is wasting. Two weeks ago i saw a sports therapist who worked on my scalenes which were incredibly tight with massage- suddenly the results started with my hand starting to get blood flow to it and the nerves were firing. I feel vindicated but i know i still have a way to go- After all the specialists i have seen i couldn’t believe the lack of understanding of this condition. I have had to fight to get an answer. Thank heavens for specialists like yourself who understand this and know how to treat this. Unfortunately i live in Australia otherwise i would love to be treated by yourself- so much more needs to be done so specialists, doctors are better informed in relation to conditions such as these.

    kind regards,
    Sean Daniels , Brisbane, Australia

    • Great story! Have your chiropractor email and text me so I can talk on the phone or Skype with him to give him some pointers on how to get the best results and fast! Thanks

      • Sean Daniels

        Thank you Dr Stoxen, I most certainly will pass on your details. My Chiro is giving me regular adjustments weekly that are freeing up the BP. I am seeing a injury therapist recommended by my chiro who is treating the scalene tightness which i’m in the second week- very encouraging results thus far- I haven’t as yet had any Manipulation of the first rib- i have clear wasting in this area. Thank you so much.

        Sean Daniels
        Brisbane, Australia

    • Hi Sean

      Thank you for your very detailed comment on the post. Your story is actually typical of hundreds of patients I have treated over the years.

      Misdiagnosis is Common! – There are so many nuances to this condition that have to be addressed in the examination that very few health care providers will even make the diagnosis of Thoracic Outlet Syndrome.

      The Skill Set Required to Reverse the Cause of the Internal Compressive Forces on the Outlet are rare. What most doctors and patients dont understand is… It is so easy to let our bodies angle outside of the perpendicular position with respect to gravity in our daily routines some of you are actually in a state of muscular stress that is creating internal compressive forces on the thoracic outlet almost every waking moment of the day. This constant strain on the muscles locks in that tonic protective reflex into the brain so deep that it takes hours of work for days to release it.

      26 hours vs 36 hours – It took me 26 hours to reverse a thoracic outlet syndrome that the doctors recommended neck surgery on a top football player this week. I told his dad it would be about 3 days of 10 hours a day but leave the two weekend days open just in case I didnt have it all out due to some unforeseen complications. We had all the internal compressive forces out by about the 24th hour and the last two I trained him hard in my gym. The signs and symptoms did not return during training so we sent him home early. He was excited but his father was really happy.

      I remember his dad calling me back after we got everything logistically set up for his flight in and lodging. He said, “Dont take this the wrong way Dr Stoxen because I respect you. I just wanted to ask you, what if this doesnt get better? Then what? I thought about it and said “You know I cannot answer that” He said, why? Because so far, that has never happened. 🙂 I think he got a vote of confidence with that one.

      With a thoracic outlet engrained in your body as bad as yours it will probably take work on the scalenes, pec minor, rotator cuff, latissimus dorsi, subclavius etc and many adjustments of the first and second ribs. I am going to put my exact hands on treatment approach for what I do to releive the pressure on the outlet via the muscles in my book so get set up with the updates with your email and Ill send you details on this.

      By the way, my last VIP client flew in from Melbourne for 3 days of intense treatment She told her chiropractor she was going to get 10 hours of treatment that day. He thought that was impossible. We did 27 hours of treatment in three days. I released her pain free for the first time in 10 years.

      You can fly into Chicago and stay a week for your treatment with us or I can talk to your doctor and tell him what will work best to get you better, Have your doctor call me or email me at 312 375 7303 team

      Thank you again for your insight and taking the time to write such a thoughtful comment! Here is a picture of Anthony Field and I in his boat adjacent to the Sydney Opera House.

      Dr James Stoxen DC

  • sharon

    I just left a long message and it must have been erased. Wondering if I have this syndrome. Symptoms are thoracic pain, left shoulder blade pain and aches, left arm, hand tingly weak. Have had several MRI, x-rays but not of thoracic area. Drs. think it is from my neck. But when the thoracic area is adjusted I feel better but it doesn’t last. My joints then ache, shoulder blade aches and feel awful all over. Sometimes my whole left side feels awful, tense, feel like cringing. Tonight my left hand got extremely weak, hard to grip even and then I raise my shoulders and the thoracic area made a cracking sound and my hand suddenly got stronger. I do get the weakness and tingling on my right side but not often and not as severe. I also get tremors in hand mostly on left but not as bad lately, mostly just weak and numb.
    Wondering if this could be TOS or what? If you have any ideas I would appreciate your sharing them.
    Thank you, sharon


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