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Are you a painter, athlete or lift heavy objects frequently and have developed sore shoulders or neck?

If you have constant shoulder and neck pain, one possible cause could be a rare condition named Thoracic Outlet Syndrome.



Thoracic outlet syndrome is a group of conditions that occur when nerves and/or blood vessels that lie between the first rib and the collarbone become compressed. This area is known as the thoracic outlet.


Common symptoms of this disorder is constant or chronic pain in the shoulder and neck. Other sure signs of this condition is numbness or tingling in the arms or fingers. Other signs include:

  • Weakening of grip in the hands
  • Discoloration or paleness in the hands or arms
  • Weakness in arm and hand strength

WHAT CAUSES IT?654259266

Thoracic Outlet Syndrome can be caused by a number of things. Most often, we see patients that have thoracic outlet syndrome because of repeated movements or injuries resulting from their career or hobbies. 

For example, painters that are normally reaching above their heads to reach trim and ceilings will exhibits these symptoms from engaging their shoulder and neck muscles. Other patients, such as baseball players use the same muscles repeatedly during practice and games. Workers who constantly lift heavy items, especially above the head can develop this condition as well.

Poor posture is a very common cause of this syndrome, as forward head posture can cause undue pressure on the shoulders.

One of the biggest culprits of TOS is sleeping with your arm behind or above your head! Dr. Johnston is an advocate against this way of sleeping!

Other patients that are diagnosed with TOS can be placed into these categories:

  • A victim of trauma such as a car crash.
  • Pregnant, as the bones and joints begin to loosen to prepare the mother’s body for a baby.

Another cause of TOS is a congenital issue in which an extra rib is grown above the first rib. In this case, there isn’t much that can be done for this, besides surgery.


One of the main ways we determine if our patients are exhibiting TOS is by attempting to replicate the pain or tingling in the extremities by pressing onto the area between the collar bone and the first rib. If the symptoms present themselves, then Dr. Johnston can safely assume that TOS is the case.

If you think you may have this syndrome, please don’t hesitate to give us a call or come on by!