Diagnosing TOS

Diagnosing TOS is hard.  It can present differently for each person.  TOS can have the same symptoms as other common disorders.  It is important to make sure a person does not have another disorder before deciding they have TOS so several tests are done. 

Your doctor will take a complete physical exam, medical history, and a history of any accidents or injuries.  They will ask what you do at your job and what kind of activities you enjoy.  The doctor will have you go for more testing to confirm you have TOS based on your symptoms.

During your physical exam, your doctor will look for signs of TOS, such as poor posture, limited range of motion, or discoloration in your arm and hand.

Additional tests performed may include:

• Nerve conduction studies to test if the nerves are working correctly
• Chest x-ray to see if you have an extra rib in your neck
• Neck x-ray to see if you have an extra rib or any spine defects
• CT scan or MRI of the spine or chest to rule out any other disorders
• Blood tests
• X -ray that uses dye to look at blood flow in your body  

Irritation Tests are meant to reproduce your symptoms.  This helps your doctor learn more about the cause of your symptoms.  These tests help rule out other health problems with similar symptoms.  The most common tests are listed below.    

Adson's Maneuver - You will turn your head toward the hurting shoulder while you extend your arm, neck, and shoulder away from your body.  Take a deep breathe and hold it, your doctor will see if your pulse is weakened or cut off.  A weakened pulse suggests compression.    

Adson's Maneuver Test

Elevated Arm Test- While sitting, your doctor will put your arm at shoulder height, moving it above your head and looks to see if your pulse is cut off. 

Wright's Test or Elevated Arm Test

Roos Stress Test (the worst 3-minutes of your life) - While sitting down, you hold both arms at shoulder height while holding your shoulders back.  You will open and close your hands for several minutes.  If your arms and shoulders become heavy, very tired, and sometimes numb, this could mean you have TOS.

Roos Stress Test