FREE BOOK THORACIC OUTLET SYNDROME Chapter I – What is Thoracic Outlet Syndrome?


You are reading Chapter I – What is Thoracic Outlet Syndrome?



by Dr James Stoxen DC

Chapter I

What is Thoracic Outlet Syndrome?

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

 Chapter I


What is thoracic outlet syndrome?


Thoracic Outlet Syndrome

Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) occurs when the nerves, veins and arteries that pass through the thoracic outlet become compressed. The thoracic outlet is the space between your collarbone (clavicle) and your first rib. This narrow passageway is crowded with blood vessels, nerves and muscles. (For more information from mayo clinic and the picture above, click here)

Some patients have severe pain at the neck, stiff neck, repeated migraines, shoulder pain, neck and should pain (feels like (Polymyalgia rheumatica) and a sense of muscle 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 as well as the nerves on the neck, 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. Nerve entrapment or nerve compression can occur because there are many areas for these arteries and nerves to get compressed.


Thoracic Outlet Anatomy

Thoracic Outlet Anatomy

That is why it’s important for you to understand the thoracic outlet anatomy so you can differentiate between venous thoracic outlet, arterial thoracic outlet syndrome, (vascular thoracic outlet), cervical ribs thoracic outlet syndrome, Polymyalgia rheumatica, thoracic outlet brachial plexus compression (neurogenic thoracic outlet), carpal tunnel syndrome, pectoralis minor thoracic outlet syndrome or maybe you have all of the above! Thoracic outlet syndrome is a very controversial subject. In fact a lot of doctors don’t think it exists. Thoracic outlet syndrome is the most difficult neurovascular compression syndrome of the extremities to manage and that is because it has a variability of complaints. It also has a difficulty in the patient compliance in the treatment and reduction of the causative factors.

History of Thoracic Outlet Syndrome

First of all, this problem is not a new problem. Galen who made the first mention of the cervical rib first mentioned it in the 2nd century AD. In 1910 Murphy gave mention of the effectiveness of the first rib resection. In 1927, Adson brought up the scalenectomy without cervical rib resection. In 1956 Deete coined the term Thoracic Outlet Syndrome.

Experience helps

Team Doctors Chiropractic Treatment and Training Centers has been around for about 57 years. It has been a practice in our family for many years. Since 1986 we have had over 30,000 new patients. From 1992 – 2012 we have had approximately 4,000 new patients with some form of peripheral nerve symptoms originating either in the neck or lower back. Statistically, we have numerous cases of thoracic outlet syndrome. We have had a great amount of experience in working with patients with thoracic outlet syndrome.

Next, Chapter II – Anatomy of Thoracic Outlet Syndrome Three Areas of Compression

Thoracic Outlet Syndrome Book




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All content on, including without limitation text, graphics, images, advertisements, videos, and links (“Content”) are for informational purposes only. The Content is not intended to be a substitute for professional medical treatment, advice, or diagnosis. Please remember to always seek the advice of a qualified physician or health professional with any questions you may have regarding any medical concerns. Dr James Stoxen DC and Team Doctors does not recommend or endorse any specific treatments, physicians, products, opinions, research, tests, or other information it mentions. Said Content is also not intended to be a substitute for professional legal or financial advice. Reliance on any information provided by Team Doctors is solely at your own risk.

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)


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