(Golden Oldie) Thoracic outlet syndrome: a controversial clinical condition. Part 2: non-surgical and surgical management

Review written by Sam Spinelli info

Key Points

  1. There are different kinds of thoracic outlet syndrome that can occur at different anatomical sites, with each having a varying level of responsiveness to conservative care.
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Thoracic outlet syndrome (TOS) is a condition that is not well understood by clinicians and the general public (1). In clinical practice, TOS is typically not a diagnosis that gets considered early on, being passed over for more common conditions such as cervical radiculopathy, frozen shoulder, rotator cuff tears, and many other pathologies, which can lead to it being mismanaged (1,2,3). TOS is a very challenging condition to treat, and it is an excellent example of the level of complexity of human anatomy and physiology (2).

Thoracic outlet syndrome is a very challenging condition to treat.
Symptom modification and a graded activity program are the essential components of conservative care for TOS.


In order to best manage this condition, it’s important to understand the underlying contributors to the symptoms and the classification of TOS (3). Assessment should initiate with patient history, watching for reports of signs and symptoms such as pain, paraesthesia,

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