About My Aches: Thoracic Outlet Syndrome

What is it?

Thoracic Outlet Syndrome, or TOS, happens when the nerves or blood vessels that run from your neck down through your shoulder and into your arm get compressed. This tight space—called the thoracic outlet—is bordered by muscles, bones, and connective tissue.

When things get too tight in that area (due to posture, injury, muscle tension, or even repetitive motions), it can lead to symptoms that affect the shoulder, arm, or hand.

There are a few different types of TOS, depending on whether nerves, veins, or arteries are affected, but all share some similar signs and frustrations.

What does it feel like?

TOS can cause a range of symptoms that may come and go, including:

• Tingling or numbness in the arm, hand, or fingers

• A heavy, tired feeling in the arm, especially when lifted

• Pain or achiness in the shoulder, neck, chest, or down the arm

• Weak grip strength or hand clumsiness

• Discoloration or swelling in more severe vascular cases

Symptoms may be noticeable when carrying heavy bags, holding the arms overhead (like when washing your hair), or sitting at a desk for long periods.

What causes it?

Some causes of TOS include poor posture, like slouching or keeping your shoulders rounded forward for long periods of time, or repetitive movements, such as lifting or carrying heavy objects, can also put extra pressure on this area. In some cases, an injury, extra rib, or even muscle tightness in the neck and chest can make the space smaller and lead to symptoms. People who habitually carry heavy loads, who do a lot of repetitive movements with their arms and shoulders, and who spend a lot of time with their arms in the air (such as athletes, electricians, plumbers, painters, etc) are more at risk for TOS than the general population.

Can Massage help?

Yes, as long as tit is confirmed that here are no major restrictions to the arteries or symptoms like blood clots, massage can be a very effective way to help manage the symptoms of TOS, especially when it’s related to muscular tension or postural imbalances.

Massage focused around the neck, shoulders, chest, and upper back can ease the tension and loosen restrictions in the tight and compressed areas. Light, long massage strokes can also help improve circulation which allows blood vessels more room to breathe and calmer stressed nerves.

What can I do on my own?

Here are some simple things you can do between sessions to support relief and recovery:

• Stretch your chest and neck: Gentle doorway stretches or ear-to-shoulder neck stretches can help reduce compression

• Watch your posture: Sit tall with your shoulders relaxed and avoid slouching or “turtling” your neck forward

• Take movement breaks: Avoid holding your arms in one position (like typing or driving) for too long

• Strengthen gently: Exercises that support the upper back and shoulder blades can help with long-term stability

• Avoid heavy bags: Switch to backpacks or redistribute weight to reduce pressure on one shoulder