Thoracic Outlet Syndrome Treatment Near Me Dallas-Fort Worth

Spine Surgery / Conditions We Treat / Thoracic Outlet Syndrome

Page Updated: August 19, 2025

Persistent pain, numbness, or weakness in your arm or hand might not be coming from your shoulder or neck—it could be Thoracic Outlet Syndrome (TOS). This complex condition occurs when the nerves or blood vessels in the narrow space between your collarbone and first rib become compressed. At DFW Spine & Pain Institute, our board-certified specialists serve the Dallas-Fort Worth, TX area with advanced diagnostics and minimally invasive treatments tailored to your unique condition.

What is Thoracic Outlet Syndrome?
Causes and Risk Factors of Thoracic Outlet Syndrome
Recognizing Thoracic Outlet Syndrome Symptoms
Comprehensive Diagnosis of Thoracic Outlet Syndrome
Treatment for Thoracic Outlet Syndrome
Prevention Strategies for Thoracic Outlet Syndrome
FAQs About Thoracic Outlet Syndrome

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome occurs when the nerves, arteries, or veins in the thoracic outlet—the narrow space between your collarbone and first rib—become compressed. This compression can result from anatomical abnormalities, trauma, or repetitive activities that affect the delicate structures in this region.

According to the Mayo Clinic, TOS affects women more frequently than men, with most cases occurring between ages 20–50.¹ The condition is particularly common among athletes in Dallas-Fort Worth who participate in overhead sports like baseball, swimming, and volleyball.

Types of Thoracic Outlet Syndrome

There are three distinct types of TOS, each affecting different structures:

Neurogenic TOS: The most common form, affecting nerves (95% of cases)

Arterial TOS: Affects arteries and can cause serious complications

Venous TOS: Affects veins, often seen in athletes and manual laborers

Causes and Risk Factors of Thoracic Outlet Syndrome

Understanding the underlying causes of TOS is crucial for effective treatment. Common causes include:

Anatomical Abnormalities

Extra cervical rib (present in approximately 1% of the population)
Abnormal muscle attachments
Enlarged scalene muscles
Fibrous bands connecting spine to ribs

Acquired Causes

Trauma: Motor vehicle accidents, falls, or sports injuries
Poor posture: Prolonged computer work or forward head posture
Repetitive activities: Overhead motions in sports or occupations
Weight gain: Can narrow the thoracic outlet space
Muscle hypertrophy: Excessive muscle development in athletes

Recognizing Thoracic Outlet Syndrome Symptoms

TOS symptoms can vary significantly depending on which structures are compressed. Early recognition is essential for preventing long-term complications.

Neurogenic TOS Symptoms

Numbness and tingling in fingers and hand
Aching pain in neck, shoulder, and arm
Weakened grip strength
Muscle wasting in the hand (advanced cases)
Pain that worsens with overhead activities²

Vascular TOS Symptoms

Arterial: Cold sensitivity, pale fingers, weak pulse
Venous: Arm swelling, bluish discoloration, prominent veins

According to the National Institute of Neurological Disorders and Stroke, early intervention significantly improves long-term outcomes for TOS patients.³

Comprehensive Diagnosis of Thoracic Outlet Syndrome

Our doctors employ a systematic diagnostic approach combining clinical assessment with advanced testing to ensure accurate TOS identification.

Clinical Evaluation

Detailed medical history focusing on symptom patterns
Physical examination including provocative maneuvers
Assessment of posture and muscle imbalances
Evaluation of occupational and athletic activities

Advanced Diagnostic Testing

Chest X-ray: Identifies cervical ribs or other bony abnormalities
MRI or CT scan: Visualizes soft tissue structures and compression
Nerve conduction studies: Assesses nerve function
Vascular studies: Evaluates blood flow when vascular TOS is suspected

Treatment for Thoracic Outlet Syndrome

At DFW Spine & Pain Institute, we take a tiered approach to treating TOS, starting with conservative therapies and progressing to more advanced solutions if needed. Our goal is to relieve your symptoms while preserving function and avoiding unnecessary surgery whenever possible.

Non-Surgical Treatments for TOS

Many patients find significant relief through targeted, non-surgical therapies:

Physical Therapy

A structured physical therapy program can help strengthen postural muscles, stretch tight areas, and reduce nerve or vascular compression.

Medication Management

We may recommend anti-inflammatories, nerve pain medications, or muscle relaxants to reduce discomfort and improve daily functioning.

Nerve Blocks

Selective nerve blocks can help identify the exact source of pain and provide temporary relief for patients with neurogenic TOS.

BOTOX^® Injections

For patients with chronic muscle tightness contributing to nerve compression, BOTOX can relax muscles and ease symptoms.

Lifestyle & Posture Coaching

Posture correction and ergonomic adjustments play a key role in long-term management and symptom prevention.

mPNS (Magnetic Peripheral Nerve Stimulation)

This non-invasive therapy stimulates affected nerves and may reduce pain and restore function in patients with nerve-related symptoms.

Ketamine Infusion Therapy

For patients with chronic TOS pain that hasn’t responded to traditional therapies, ketamine can help calm overactive nerve signaling.

Advanced & Surgical Options

If non-surgical approaches fail to provide lasting relief, we may explore more advanced interventions in collaboration with your care team:

Vascular Surgery Consultation

Patients with arterial or venous TOS may require surgical decompression or vascular repair performed by a specialized surgeon.

Minimally Invasive Decompression

In select cases of neurogenic TOS, minimally invasive procedures may be used to release the scalene muscles or remove an extra rib.

Surgery is always a last resort, and our team will guide you through your options with compassion, clarity, and evidence-based recommendations.

Prevention Strategies for Thoracic Outlet Syndrome

Preventing TOS involves addressing modifiable risk factors and maintaining optimal musculoskeletal health:

Maintain proper posture: Especially during computer work and daily activities
Regular exercise: Focus on strengthening postural muscles
Ergonomic workspace: Proper desk height, monitor position, and keyboard placement
Avoid repetitive overhead activities: Take frequent breaks during prolonged overhead work
Weight management: Maintain healthy body weight to reduce compression risk

FAQs About Thoracic Outlet Syndrome

When should I seek treatment for symptoms of Thoracic Outlet Syndrome?

If you experience persistent numbness, tingling, swelling, or weakness in your arm or hand—especially with overhead activity—you should seek medical evaluation. Sudden color changes, swelling, or loss of sensation should be treated as urgent symptoms.

Can Thoracic Outlet Syndrome be cured?

Some cases of TOS can be completely resolved with proper therapy and lifestyle modifications. Others may require ongoing management or surgical correction, depending on the underlying cause.

How long does it take to recover from TOS treatment?

Recovery time varies. Patients who respond well to conservative treatment may feel better in a few weeks to months. Surgical recovery can take longer and involves physical therapy for optimal results.

What happens if TOS is left untreated?

If ignored, TOS may lead to permanent nerve damage, chronic pain, or vascular complications such as blood clots or embolisms. Early diagnosis and intervention are key.

Is Thoracic Outlet Syndrome common in athletes?

Yes. Athletes who perform repetitive overhead motions—like swimmers, baseball players, or weightlifters—are at higher risk for developing TOS due to muscle enlargement and repetitive strain.

Get a FREE MRI Review at DFW Spine & Pain Institute

If you have had an MRI but you are still suffering from pain, our specialists offer free MRI reviews. We offer a variety of treatment options at conveniently located offices in Colleyville, Dallas, Frisco, and Rockwall, Texas. Contact us with any questions or to schedule a consultation.

Get a FREE MRI Review

Sources

¹ Mayo Clinic. Thoracic Outlet Syndrome. Available: https://www.mayoclinic.org/diseases-conditions/thoracic-outlet-syndrome/symptoms-causes/syc-20353988. Accessed August 1, 2025.
² Cleveland Clinic. Thoracic Outlet Syndrome. Available: https://my.clevelandclinic.org/health/diseases/17553-thoracic-outlet-syndrome-tos. Accessed August 1, 2025.
³ National Institute of Neurological Disorders and Stroke. Diagnosis of Thoracic Outlet Syndrome. Available: https://medlineplus.gov/thoracicoutletsyndrome.html. Accessed August 1, 2025.

The Doctors at DFW Spine & Pain Institute have either authored or reviewed and approved this content.