Thoracic Outlet Syndrome

Ever have a strange sensation running down your arm…tingling, aches, pain that you can’t quite place? There’s a few different types of nerve entrapment it may be and thoracic outlet syndrome is one of them.

It’s an issue that’s been affecting my left arm on-and-off for the past 20 years. My tricep ached, grip went weak and it felt as though my arm was dangling from the shoulder by a few threads.

These days I better understand what’s going on and have developed a self-care system to take care of it as soon as I feel a slight tingle.

But years ago I had no idea what it was or what to do about it, so at times it got pretty bad.

I’d go see my chiropractor or massage therapist to work on it and suggest you do the same if you’re feeling some type of nerve issue.

In fact, let me say this now…if you’re feeling tingles, burning pain or numbness, go see a chiropractor today if you haven’t done so already. Before trying any of the stretches or exercises in this post, talk to a medical professional to make sure you don’t have a more serious underlying issue that may be made worse.

But once your doctor gives you the go ahead, I recommend you begin developing your own self-care practice so you’re less likely to end up in a painful state of emergency.

thoracic outlet syndrome

Thoracic outlet syndrome is the compression of veins, arteries and the nerve structure called brachial plexus.

The brachial plexus is where the nerves for your arm make their way from your spine through the muscles and bones in your neck, between the clavicle and first rib and then through your armpit.

It can feel like sharp or burning pain and possibly even tingling or numbness running down your arm.

thoracic outlet syndrome

The literature is clear that a scalene muscle problem is primarily responsible for neural or vascular entrapment in many patients who are commonly diagnosed as having thoracic outlet syndrome.

The picture above gives you an idea how a tight anterior scalene can do that by pulling up on the first rib.

And in this next image, you can also see how a tight pec minor could do something similar.

thoracic-outlet-syndrome- (1)

I’m lucky enough to have entrapment in both locations.

So not only have I taken the strategy I’m about to share with you from one of the best texts in the world on this subject, but I’ve personally tested it many times with excellent results.



It’s helpful to figure out why these two muscles are tight in the first place so you can begin searching for ways to address them. Some causes are:

  • Fall or accident
  • Playing certain musical instruments
  • Sleeping with your neck bent
  • Scoliosis
  • Paradoxical breathing
  • Competitive swimming
  • Heavy lifting
  • Handling horses
  • Leg length inequality
  • Hemi-pelvis when seated
  • A habit of leaning to one side


It may take some time to figure out what you are doing to cause this issue but when you do, take note. And then try changing how you do things in the future.

For me, I noticed that I often lean to the right when standing and seated. This causes my left scalenes to get tight by holding my head up for extended periods of time.

My left pec minor often gets tight due to the way I sleep on my left side with my shoulder all scrunched up in front.

STEPs 3&4RELEASE TRIGGER POINTS and stretch tight muscles

As I just mentioned, there are two main muscles that when tight, can compress the brachial plexus, causing your thoracic outlet syndrome.

The first is the anterior scalene.

If that seemed to help, go ahead and release the sternocleidomastoid also. The two of them are so closely related that trigger points in the sternocleidomastoid can cause them to come back in the scalenes.

Now for the pectoralis minor.

If releasing the pec minor helped, then I suggest you release any trigger points in the pec major as well.


If your pec minor was tight, then you likely have a weak lower trapezius on the same side. The two are opposing muscles pulling on your scapula…pec minor tilts it anteriorly and lower trap tilts it posteriorly.

It’s a funny muscle to isolate but when you get it to engage, you’ll feel it right away.

Thoracic outlet syndrome is just one type of nerve entrapment that affects the arm. You can also check out my post on ulnar nerve entrapment.

If you’ve dealt with nerve entrapment yourself, leave a comment below about what it was and how you dealt with it.


Myofascial Pain and Dysfunction: The Trigger Point Manual Volume 1. Upper Half of Body Janet G. Travell, M.D., David G. Simmons, M.D. ,1999 Williams & Wilkins


  • Hello, This is a very interesting article/video presentation. My other problem is tingling in my left leg below the knee and on occasion muscle cramp on the front of the foot and front of the lower leg. Looking forward to any ideas that you may have. Thank you!

  • Thanks Suzanne. I haven’t started anything on the leg yet, but you’ll know when I do. In the meanwhile, I highly recommend seeing a chiropractor or physical therapist to find out exactly what’s going on, if you haven’t already.

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