Can Massage Help Thoracic Outlet Syndrome?

Have you ever experienced numbness and tingling in the arm and maybe even down into the hand, and your doctor has ruled out carpal tunnel? The issue might not be in your hand or wrist; it might be Thoracic Outlet Syndrome (TOS).

The thoracic outlet is a narrow space between your collarbone and the top of your first rib. Muscles, nerves, and blood vessels run through the opening or “tunnel.” When the tunnel becomes blocked, it can cause dysfunction in the nerves and other structures that run through it.

There are three types of thoracic outlet syndrome: neurogenic venous, and arterial. The latter two are sometimes grouped together and referred to as vascular TOS. Although vascular TOS is rare, it can be severe. It can be caused by a blood clot or an aneurysm in the veins or arteries under the collarbone. Because of the severe nature of these types of TOS, it’s wise to get a diagnosis from a physician or physical therapist to rule out vascular TOS before seeking massage as treatment since massage could cause more harm.

If you experience any of the following symptoms, consult your primary care doctor immediately.

● Bluish coloring of hand

● Paleness in one or more fingers

● Swelling in the arm or hand

● Cold feeling in the hand or arm

● Throbbing lump under the collarbone

● Blood clots in the upper body

● Weak grip

The third type, Neurogenic TOS, can be treated with massage and makes up the majority of cases. We will be discussing this type for the remainder of today’s post.

Neurogenic TOS affects the brachial plexus bundle; nerves come from your spinal cord at the cervical spine and lead from the neck down to the arm. As a result, muscles in the neck and shoulder become too tight and impinge or clamp down on the brachial plexus. This can cause pain in the neck, shoulder, or arm, tingling, numbness, and weakness which is why it’s often misdiagnosed as carpal tunnel. Symptoms can be consistent or come and go and are usually worse when arms are raised above the head or upon waking in the morning after sleeping on the shoulder of the affected arm.

What causes TOS?

TOS can have a variety of causes, including traumatic injuries like whiplash, overdeveloped muscles from bodybuilding, and repetitive posture from a job or hobby that causes a person’s head to come forward excessively, causes their shoulder to roll forward, or requires them to have their arms over their head a lot. However, TOS can also have no known cause or origin.

Hairdressers, auto mechanics, carpenters, and plumbers are some of the professions more likely to develop TOS than others due to the body mechanics required to perform their job. Individuals who work on computers for long periods, housekeepers, and people who enjoy hobbies like swimming or painting can also develop TOS. Even carrying a heavy shoulder bag, purse, or briefcase over a long period can result in someone developing TOS. A structural anomaly like an extra rib can also be a contributing factor.

So, can massage help? Yes, maybe, probably. It depends on whether a structural or functional anomaly causes the TOS.

If the TOS is caused by a structural anomaly such as subluxations in the cervical spine or an extra rib, it’s best to consult a physical therapist, chiropractor, or osteopath to free up a cervical spine impingement first. Addressing both structural and functional causes of TOS can provide more long-term relief.

If the TOS is caused by a functional anomaly such as tight neck muscles, overuse, or positional and postural issues, techniques that target trigger points can help relieve muscle tension and reduce or eliminate muscle-related nerve impingement. Gentle stretching and passive range of motion with a mild pin and stretch of soft tissue can help restore full movement to the area.

How do you keep TOS from coming back?

Short of a career change or new hobby, those with TOS may experience recurring symptoms if they do not take care of causes such as tight muscles, repetitive movement, or poor posture between sessions.

Self-myofascial trigger point release, followed by gentle stretching, are great between-session exercises to help manage TOS.

Using a tool like a Theracane or a tennis or lacrosse ball against the wall or lying on the floor can help release tension by targeting specific tender spots in the muscle tissue. Your massage therapist can help identify which muscles to focus on and ensure you’re doing the exercise correctly. You don’t want to risk further nerve damage or damage to veins and arteries.

Remember, just because it feels good doesn’t mean you need to dig in deeper; you might be doing more damage this way. Consulting a physical therapist for strengthening exercises to improve your posture will also help. Thoracic Outlet Syndrome doesn’t have to stop you from doing the things you enjoy.

References:

https://www.webmd.com/brain/thoracic-outlet-syndrome#091e9c5e81bcb7f3-1-3

https://www.hopkinsmedicine.org/health/conditions-and-diseases/thoracic-outlet-syndrome

https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988