Thoracic Outlet Syndrome Symptoms: 5 Tests You Can Do At Home

Thoracic outlet syndrome symptoms often mimic carpal tunnel syndrome, which is why the condition is frequently overlooked or misdiagnosed.

Many people experience numbness, tingling, weakness, arm pain, neck pain, or hand symptoms for months before discovering the true cause. Fortunately, several simple tests can help determine whether thoracic outlet syndrome may be responsible for your symptoms.



This guide explains the most common thoracic outlet syndrome symptoms and shows you five clinical tests that doctors commonly use to evaluate the condition.

Thoracic outlet syndrome (TOS) occurs when nerves or blood vessels become compressed in the narrow space between the collarbone and first rib. More than 1 in 50 Americans may have some form of thoracic outlet syndrome.

The condition is not a single disorder. Instead, thoracic outlet syndrome is divided into three categories:

• Neurological thoracic outlet syndrome (nerve compression)
• Vascular thoracic outlet syndrome (blood vessel compression)
• Nonspecific thoracic outlet syndrome (uncertain cause)

Physical trauma is one of the most common causes. Many patients develop symptoms following:

• motor vehicle accidents
• sports injuries
• repetitive strain injuries
• pregnancy
• occupational overuse

Most patients improve with physical therapy and conservative treatment, although surgery may occasionally be necessary when severe compression persists.

The symptoms of thoracic outlet syndrome depend on whether nerves or blood vessels are being compressed.

Neurological Thoracic Outlet Syndrome Symptoms

Common nerve-related symptoms include:

• numbness or tingling in the arm, hand, or fingers
• pain in the neck, shoulder, arm, or hand
• loss of grip strength
• weakness
• muscle wasting at the base of the thumb (thenar atrophy)

Symptoms often worsen when the arm is elevated above shoulder level.

Vascular Thoracic Outlet Syndrome Symptoms

Common blood vessel-related symptoms include:

• bluish discoloration of the hand
• pale fingers
• cold fingers, hands, or arms
• arm swelling
• weak or absent pulse
• blood clots
• throbbing lump near the collarbone
• arm fatigue during activity
• numbness or tingling 

Vascular symptoms are generally less common than neurological symptoms but tend to be more serious.

Thoracic outlet syndrome and carpal tunnel syndrome often produce similar symptoms, which makes diagnosis difficult.

Both conditions may cause:

• numbness
• tingling
• weakness
• loss of grip strength
• hand pain

The difference is location.

• Carpal tunnel syndrome results from compression of the median nerve at the wrist.
  
• Thoracic outlet syndrome results from compression much higher in the body, near the neck, shoulder, collarbone, and first rib.

Because of this, thoracic outlet syndrome often produces symptoms involving the neck, shoulder, entire arm, or circulation problems that are not typically seen with carpal tunnel syndrome.

If you have thoracic outlet syndrome symptoms, the following five tests may help identify the condition.

These are the same clinical maneuvers many doctors use during an office examination.

You will need:

• a willing partner
• a quiet room without distractions
• a chair without armrests
• enough space to move comfortably

Each test attempts to temporarily increase compression within the thoracic outlet. A positive test reproduces symptoms or causes changes in circulation.

If one or more tests are positive, thoracic outlet syndrome becomes more likely.

These tests are screening tools only and should not replace a medical evaluation.

You should seek medical evaluation if you experience:

• persistent numbness
• arm weakness
• loss of grip strength
• worsening pain
• cold fingers
• arm swelling
• discoloration of the hand
• symptoms that interfere with work or sleep

Early diagnosis is important because prolonged nerve or blood vessel compression may result in permanent damage.

Many patients initially assume they have carpal tunnel syndrome when the true problem originates higher in the shoulder and neck region.

Thoracic outlet syndrome symptoms commonly include numbness, tingling, weakness, pain, cold hands, arm fatigue, and circulation problems.

The condition develops when nerves or blood vessels become compressed between the collarbone and first rib.

Five common physical examination tests may help identify thoracic outlet syndrome:

• Elevated Arm Stress Test
• Adson Test
• Costo-Clavicular Test
• Allen Test
• Provocative Elevation Test

Although these tests can help identify the condition, a medical evaluation is often necessary to confirm the diagnosis and rule out other disorders such as carpal tunnel syndrome.

Because thoracic outlet syndrome frequently mimics carpal tunnel syndrome, proper diagnosis is essential before beginning treatment.

• Thoracic outlet syndrome occurs when nerves or blood vessels become compressed near the collarbone and first rib.
• Symptoms may include numbness, tingling, weakness, pain, cold hands, and arm fatigue.
• Thoracic outlet syndrome is frequently mistaken for carpal tunnel syndrome.
• Five common clinical tests may help identify the condition at home.
• Positive tests often reproduce symptoms or temporarily alter circulation.
• Most patients improve with conservative treatment such as physical therapy.
• Early diagnosis may help prevent long-term nerve or blood vessel damage.