33 Central Ave Midland Park NJ 07432

Thoracic Outlet Syndrome Treatment in Waldwick, NJ

What Is Thoracic Outlet Syndrome?

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Thoracic outlet syndrome (TOS) is a group of conditions which develop when the nerves or blood vessels in your thoracic outlet—a narrow passageway between your collarbone and first rib—become compressed. The compression can result in tingling, numbness, and pain felt in the neck, shoulder, arm, and hand.

There are several different types of thoracic outlet syndrome:

  • Neurogenic: A compression of one or more brachial plexus nerves
  • Vascular: A compression of the subclavian vein
  • Arterial: A compression of the subclavian artery

TOS can cause a number of serious cardiovascular or neurological conditions if left untreated. To schedule a consultation with a healthcare practitioner in Waldwick who specializes in thoracic outlet syndrome treatment, call (201) 806-6099 or contact Dr. M.T. Shahab online.

Thoracic Outlet Syndrome Causes

Thoracic outlet syndrome causes compression of the nerves or blood vessels and can result from an injury, disease or congenital defect. However, the reason for TOS compression is not always understood; these kinds of thoracic outlet syndromes are sometimes referred to as nonspecific-type or disputed.

There are several factors that can increase your likelihood of developing TOS, including:

  • An extra rib above the first rib
  • Overuse of the shoulder or arms
  • Poor posture
  • Obesity
  • Sports injuries or weightlifting
  • Whiplash injury (injury to the neck or back)
  • Tumors or large lymph nodes in the collarbone area

Thoracic Outlet Syndrome Symptoms

Thoracic outlet syndrome symptoms vary between the different kinds of TOS.

In neurological thoracic outlet syndrome, symptoms can include:

  • Numbness or tingling in the arms or fingers
  • Aching pain in the neck, shoulder, or hand
  • Decreased size of hand muscles
  • Weakened grip

Symptoms of vascular or arterial thoracic outlet syndrome include:

  • Discoloration, swelling, and coldness in the extremities
  • Fatigue in the arms or hands

Thoracic Outlet Syndrome Tests

If your healthcare practitioner suspects you have thoracic outlet syndrome, a physical exam to review your symptoms is necessary. Your provider may recommend a provocation test in which he or she attempts to reproduce your symptoms. This may involve moving your neck, shoulders, and arms into different positions.

If TOS is discovered, specific thoracic outlet syndrome tests can be administered to determine if the TOS is vascular, arterial, or neurogenic in nature. For arterial and vascular TOS, an arteriography or venography is used to analyze disturbances in blood flow. Both tests use a small catheter—inserted from your groin into your major arteries or veins—to inject a dye that makes your circulatory system appear on an X-ray, MRI or CT scan. Ultrasounds may also be used to see inside the thoracic outlet.

TOS tests that directly address neurogenic TOS include:

  • Electromyography : An electrode is inserted into your skin and muscles to measure electrical activity. This can help your healthcare provider determine if the muscles and nerves in the thoracic outlet are working properly.
  • Nerve conduction study , which measures the speed of your nerve impulses to muscles throughout the body to determine whether or not you have nerve damage.

Thoracic Outlet Syndrome Treatment

Treatment options for thoracic outlet syndrome vary, depending on its type. However, the sooner that TOS is detected, the greater the likelihood of successful treatment. Common treatments can include lifestyle changes, physical therapy, medications, and if need be, surgery.

Lifestyle and Physical Therapy

Though it may not be possible to prevent thoracic outlet syndrome, there are various lifestyle changes one can utilize to reduce symptoms and prevent the condition from returning. These include:

  • Maintaining a healthy weight
  • Avoiding repetitive movements
  • Practicing strengthening exercises
  • Practicing good sitting and standing posture
  • Taking frequent breaks to stretch and move around
  • Avoid lifting heavy objects or carrying bags over your shoulder

For neurogenic TOS, physical therapy can be used to improve the range of motion of the neck and shoulders and to strengthen muscles. Most patients do see an improvement with thoracic outlet syndrome physical therapy treatment, as it can help patients improve their posture and relieve the pressure on the thoracic outlet.


Medications to treat neurogenic TOS include over-the-counter painkillers and muscle relaxers. For arterial and vascular TOS, medication is used to reduce the risk of blood clots or pulmonary embolism. These medications include both thrombolytic medications to dissolve blood clots and anticoagulant medications to prevent blood clots from forming.

Thrombolytic medications are injected into a vein through a catheter by a medical professional, causing the clot to dissolve within a matter of hours or days. In some cases, a balloon may be inserted into the vein to keep it opened—known as an angioplasty—in order to prevent more blood clots from forming.


Thoracic outlet syndrome surgery is usually recommended when symptoms are severe or when conservative treatment options have proven unsuccessful.

For neurogenic TOS, decompression surgery can be used to remove the first rib, abnormal muscles, or fibrous bands to relieve the pressure on the thoracic outlet. For arterial and vascular TOS, surgery can also be used to repair any damage done to the artery or vein.

Oftentimes, surgery and medications are used together: In vascular TOS, surgery is often preformed after a thrombolytic medication treatment, and in arterial TOS, thrombolytic medication is preformed after an operation.

Seek TOS Relief Today!

If you experience symptoms of thoracic outlet syndrome, it is important to seek medical care. Thoracic outlet syndrome can cause a lot of discomfort and lead to serious complications if not properly treated. Some of these conditions include:

  • Gangrene
  • Permanent nerve damage
  • Ischemic ulcers—or open sores—in the fingers
  • Permanent arm swelling and pain
  • Blood clots and conditions like pulmonary embolism

To schedule an appointment with a thoracic syndrome specialist in Waldwick, call (201) 806-6099 or contact Dr. M.T. Shahab online.

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Hours and Directions
Medwell Orthopedics & Functional Medicine for Men & Women


33 Central Ave
Midland Park, NJ 07432
(201) 806-6099


Mon: 8:00 am - 8:00 pm
Tue: 2:00 pm - 7:00 pm
Wed: 8:00 am - 6:30 pm
Thu: 8:00 am - 1:00 pm
Fri: 8:00 am - 6:30 pm
Sat: 9:00 am - 1:00 pm
Sun: By Appointment Only

Areas We Service:

Allendale, NJ, Fair Lawn, NJ, Franklin Lakes, NJ, Glen Rock, NJ, Hackensack, NJ, Ho Ho Kus, NJ, Paramus, NJ, Ramsey, NJ, Ridgewood, NJ, Saddle River, NJ, Waldwick, NJ, Wyckoff, NJ, Hawthorne, NJ, Paterson, NJ