Hi Jenny,
Nice to say welcome to the orum, but sorry it is for investagating TOS.
This is a link I often refer for symptoms that are covered for TOS.
http://www.nismat.org/ptcor/thoracic_outlet/
Thoracic outlet is the area behind the collar bone and in front of the first rib that the vascular bundle, and the brachial nerve bundle of the cervical nerves C5/6/7/8 &T/1. They are one long cell that travel three feet to the finger tips, branching off into the major nerves of the arm and hand.
The picture shows the site, this lies behind the collar bone, if your press behind the collar bone about midway from the center to shouldre, press inward preety good it should be tender.
Also, if you raise your arms like your are being robbed, up and back, AND I MEAN BRING THEM BACK. Raise so elbows are at the shoulder height hands open face forward, (Feel in in the center in the back of you are doing it right),
Now hold them up for three minutes close and open the hands, waht do you feel and where? Stop when you have to, it there is pain, heaviness, symptoms or too much fatigue.
We want to feel better so we tend to let our arms come forward doing this, but to close the outlet to compress if the nerves are being compressed, you need to get back and feel like the wings are going to each other not rounding your shoulders so it feels better.
Others will be along to put some thoughts in also.
The one important thing to diagnosisng is to understand, many doctors can say they think you may have TOS, but they have likey never seen a case or know how to treat it.
Find a TOS specialist. They will take about 2-3 hours to review records, reproducing testing, order test that you may need to assist in diagx..ie) rule out other syndromes.
Dianne
What causes the neurovascular compression?Compression occurs when the size and shape of the thoracic outlet is altered. The outlet can be altered by exercise, trauma, pregnancy, a congenital anomaly, an exostosis, postural weakness or changes.
Below is a list of the component syndromes which comprise thoracic outlet syndrome along with a brief description of each. Refer to the scheme for questions about the gross anatomy of the region.
Anterior scalene tightness
Compression of the interscalene space between the anterior and middle scalene muscles-probably from nerve root irritation, spondylosis or facet joint inflammation leading to muscle spasm.
Costoclavicular approximation
Compression in the space between the clavicle, the first rib and the muscular and ligamentous structures in the area-probably from postural deficiencies or carrying heavy objects.
Pectoralis minor tightness
Compression beneath the tendon of the pectoralis minor under the coracoid process-may result from repetitive movements of the arms above the head (shoulder elevation and hyperabduction).
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What sort of activities can cause these compression syndromes?Thoracic outlet syndrome has been described as occurring in a diverse population. It is most often the result of poor or strenuous posture but can also result from trauma or constant muscle tension in the shoulder girdle.
Static postures such as those sustained by assembly line workers, cash register operators, students of, for example, those who do needle work often result in a drooping shoulder and forward head posture. This position of the shoulders and head is also indicative of poor upper body posture. Middle aged and elderly women who suffer from osteoporosis often display this type of posture as a result of increased thoracic spinal kyphosis.
Carrying heavy loads, briefcases and shoulder bags can also lead to neurovascular compression. Humans are not well adapted as beasts of burden and heavy loads hung form the shoulders and arms can stress the supporting structures of the shoulder girdle which is basically suspended by the clavicle and all of the component ligaments and muscles.
Occupations which require repetitive over head arm movements can also produce symptoms of compression . Electricians, painters and plasterers may develop hyperabduction syndrome. Compression of the neurovascular structures also occurs in athletes who repetitively hyperabduct their arms. Swimmers, volleyball players, tennis players and baseball pitchers may suffer compression of the neurovascular structures as well. However, compression of these structures may be caused by stretching or microtrauma (small tears in muscle tissue) to the muscles which support the scapula.
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Are there other causes of thoracic outlet syndrome?Some people are born with an extra rib right above the first rib. Since this intersection of nerves, vessels, muscles, bones and ligaments is already quite involved one can imagine what the presence of an extra rib in the region might do. A fibrous band extends from this cervical rib to the first rib causing an extra bend in the lower part of the brachial plexus which may produce a compression in this region.
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How is thoracic outlet syndrome treated?The first step to beginning any treatment begins with a trip to the doctor. Make a list of all of the symptoms which seem to be present even if the sensations are vague. Make a note of what activities and positions produce or alleviate the symptoms and the time of day when symptoms are worst. Also, note when the symptoms first appeared. This list is important and should also include any questions one may have.
Due to overlapping in terms of symptoms it’s difficult to make a definitive diagnosis; this is why a list is so important. Certain diagnostic tests have been designed which are very useful for examination. These tests involve maneuvers of the arms and head and can help the practitioner by providing information as to the cause of the symptoms and help in designing an approach to treatment. These tests, accompanied by a thorough history help in ruling out other causes which may produce similar symptoms. These include Pancoast tumor, neurofibromas, cervical spondylosis, cervical disk herniation, carpal tunnel syndrome and cubital tunnel syndrome. Don’t forget to ask your practitioner about these conditions as well.
Here are a few more commonly applied provocation tests used in the diagnosis of thoracic outlet syndrome. These tests may or may not momentarily reproduce symptoms but as was mentioned earlier are important in ruling out other causes which may produce similar symptoms.
EAST Test or "Hands-up" Test
The patient brings their arms up as shown with elbows slightly behind the head. The patient then opens and closes their hands slowly for 3 minutes. A positive test is indicated by pain, heaviness or profound arm weakness or numbness and tingling of the hand.