Conditions we treat
Thoracic outlet syndrome
For arm pain, numbness, tingling, or heaviness from nerves squeezed between the neck and shoulder.
What it is
Thoracic outlet syndrome (TOS) happens when the nerves or blood vessels that travel from the neck to the arm get squeezed, often by tight neck or chest muscles or under the collarbone. In teens and young adults it is usually the nerve type, and it is common in overhead athletes like swimmers, pitchers, and volleyball players.
It is often missed or mistaken for other problems, and many patients improve without surgery. Sudden arm swelling or color change can mean a blood vessel is involved and needs prompt medical attention.
Common reasons patients come to us
- Numbness or tingling in the arm or hand
- Arm heaviness or fatigue, especially overhead
- Neck, shoulder, or chest pain
- Headaches that start in the neck
- Hand weakness or clumsiness
- Symptoms worse when reaching overhead or carrying
How we find the source and treat it
Finding the source
A careful exam, including arm and neck positions that reproduce symptoms, with ultrasound and other testing when it will change the plan.
Rehabilitation
Therapy for posture, breathing, shoulder blade control, and muscle balance, plus nerve gliding exercises, with a plan to get back to overhead activity.
Muscle blocks
Ultrasound-guided blocks of the scalene and pectoralis minor muscles, which can confirm the diagnosis and relieve symptoms.
Botox
Botox for tight muscles that keep squeezing the nerves, when blocks show those muscles are the source.
Medications
Medications for nerve and muscle pain, matched to your symptoms and what you need to do day to day.
Working with surgeons
We aren’t surgeons, but we work closely with them. How you respond to treatment helps show who is likely to benefit from surgery, and we refer when it’s the right answer.
Why it often comes with other problems
TOS rarely travels alone. Neck pain, headaches, shoulder problems, and hypermobility are common companions, and nerve pain that has been going on for a while can make the whole arm more sensitive.
We treat those pieces in the same plan, including neck and shoulder problems, headaches, and nerve sensitivity, and we coordinate with your physical therapist, athletic trainer, and other doctors so recovery doesn’t stall on the one thing nobody looked at.
Often travels with
Ready to start?
Book online in a few minutes. No referral needed. We see children, teens, and young adults up to age 30 in Greenville, Charlotte, and by telehealth in SC and NC.