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Case study on TOC - Thoracic Outlet Syndrome




A 48 yr old male complaints of occasional numbness and tingling sensation down his fingers after sitting for long hours. he is active in the gym and does a lot of weightlifting exercises to develop his arm and chest muscles. His symptoms worsened since he started working from home. He complaints of:


- Tightness in the left neck and chest muscles

- Tingling down his fingers

- Occasional numbness in the fingers when he wakes up in the morning


He has consulted a doctor regarding his concerns, had an MRI done and results shows no sign of nerve compression arising from his neck. He was referred for physiotherapy for conservative treatment.


Upon assessment, he has rounded shoulders, tight chest muscles, weak back muscles and his shoulder blades are not quite sitting in place. he does not complaint of abnormal cold sensation at his fingertip and has normal capillary refill time (2-3seconds)


Over the course of 3 weeks, his physiotherapy treatment included:

- Release of the pectoralis muscles(chest muscles)

- Shoulder blade and 1st rib mobilization

- Muscle stretching and strengthening of the chest, arms, neck and upper back

- Ergonomics and work station set up tips


His symptoms has reduced significantly however he still needs to continue with his corrective muscle strengthening, stretching and to be mindful of his posture to reduce the risk of compressing the nerve at the thoracic outlet region.

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