Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is essentially the nerves which run down your arms being pinched below the more common level of the neck. TOS is often confusing, because it shades into other common problems including costochondritis, pectoralis minor impingement, and the iHunch. Although these are all separate labels, actually there’s a large amount of overlap.

The iHunch is the name we give to the immensely common hunched upper back which drives most neck pain and headache. This is a tsunami - the numbers are going up like a sky rocket as more people hunch more over laptops, tablets and smartphones. It’s covered in detail on our iHUNCH page.

As the upper back hunches, your shoulders pull forward, and the pec muscles on your chest get tight and bunched. The nerves and blood vessels which run down your arms come out the low part of your neck and the upper part of your back and run out through this hunched, constricted, tight area. If some bits in the area are tight enough, they can partially cut off the blood supply (like someone standing on a garden hose) and also trap the nerves running down your arms (causing referred pain, tingling and/or numbness down the arms).

This is generally called thoracic outlet syndrome (TOS) and is a sort of general term for enough impingement through the area to cause arm symptoms. Pec minor impingement is another term, for specific muscle tightness on your chest trapping the blood supply or nerves which run under it. It’s often just part of TOS, which is often just part of the iHunch.

The iHunch is now probably the biggest cause of new costochondritis chest pain. When the upper back hunching gets tight enough, the rib joints on your spine also tighten and freeze. When they can’t move, the joints at the other ends of the same ribs on your breastbone HAVE to move excessively, just to let you breathe. So these hinges strain, give, irritate, get inflamed - and welcome to costo. More detail on our COSTOCHONDRITIS page.

The point is that usually none of these problems happen in isolation. They all overlap and flow into each other. Basically, they’re all the sort of problems humans get when they start to get hunched and tight, and various specific structures start to trap nerves or blood vessels. So, sure, you can commonly get more than just the one problem.

Surgeons in particular will usually focus on just the one specific bit they can release with a scalpel. This may indeed be needed, but that bit is hardly ever just in isolation, and you usually need the whole interrelated hunching bundle sorted out to get a good and lasting result. There’s a good diagram on our iHUNCH page showing the collection of bits that need dealing to, and a home program for it which includes strengthening, stretching, massage, posture, the Backpod, etc.

The Backpod: You can hardly ever fix any of these problems with just one single, simple intervention - whether it’s surgery, a pill, manipulation, etc. They’re multi-factorial problems, so you need to get around all of the bits. The Backpod with its simple home program of stretching, strengthening, home massage and posture is a single package covering each of the wider basics you need to get straight and flexible again. This is the key to getting the full benefits of any specific treatments you may also have had, including manipulation and any surgery.