Treatments

There are no set treatment guidelines for TOS and vary depending on your symptoms and type of TOS.  Treatment usually does not involve surgery. 

Neurogenic TOS

Physical therapy and lifestyle changes are the common starting point.  These treatments are helpful in 90% of people with TOS.  The goal of physical therapy is to increase the space of the thoracic outlet.  This is done by stretching, strengthening exercises, and promoting better posture.  Lifestyle changes involve doing daily activities in a way that does not increase your pain, changing your workstation set up, and avoid lifting heavy objects above your head. **It is VERY important to see a physical therapist that is familiar with this disease**

                Important TOS exercises

NERVE GLIDES (refer to nerve glide tab)

Practice good posture

Relaxation exercises

Stretching

Strength exercises (stomach muscles, pelvis muscles, muscles that help maintain proper posture)

Medications- Tylenol or ibuprofen may lower your pain.  If needed, your doctor may prescribe a muscle relaxer for extra pain relief.

Surgery may be needed if previous treatments do not reduce symptoms. 

Venous TOS

Medications to dissolve blood clots are given at the hospital so a person can be watched closely.  The medicine is given directly in a vein or by a long skinny tube guided through the vein to the area near the blood clot.  The blood clot breaks up over a few hours to a few days.

Blood thinners can be used to lower the blood's ability to clot.  A doctor will tell you how to take this type of medicine on your own. 

Surgery may be needed along with medication to manage your symptoms.  Surgery is suggested after the clot in the vein has been treated/removed with medicine. 

Arterial TOS

Medications to dissolve blood clots are given at the hospital so a person can be watched closely.  The medicine is given directly in the artery or by a tube guided through the artery to the area near the blood clot.  The blood clot breaks up over a few hours to a few days.

Surgery is often required to create more space around your neck and collarbone.  Surgery may be done to repair any damage to the artery.