Thoracic Outlet Syndrome or TOS is considered a compression disorder of the bands of nerves into the arm called the brachial plexus and the accompanied vessels consisting of the Subclavian Artery and Vein. The compression may arise from compression either at the Anterior Scalene, the Pectoralis Minor, or a combination of both resulting in a radicular nerve sensation at C5-6, but mostly C8-T1, paresthesia  which is found 90% on ulnar side, a positive Adson’s Test most likely, a positive finding of Tinel’s sign at Erb’s point for Radial nerve  +/or the Ulnar nerve, and TMJ tenderness of the symptomatic side 68%. As discussed in other areas of this website, scoliosis, lateral bends of the spine, and a dysfunctional pelvis all have contributing aspects to the rest of the body. TOS also may have a lateral cervical (neck) flexion to symptomatic side, C-type scoliosis seen 80% and 20% S-type, a pelvic tilt 90% towards injured side, and oddly enough possible Coccigodinia with a cutaneous response 50% of the time (8).


(1) Acute Muscle Stretching Inhibits Maximal Strength Performance

Joke Kokkonen Physical Education Division , Brigham Young University-Hawaii Campus , USA , Arnold G. Nelson Department of Kinesiology , Louisiana State University , USA & Andrew Cornwell

Pages 411-415 | Accepted 30 Mar 1998, Published online: 08 Feb 2013

(2) Dynamic Gait Assessment for Chiropractors

IN Chiropractic & Wellness, Inc. / Indiana Scoliosis Specialists, McDougle Chiropractic Methods Research Center, Fishers Indiana, USA

Dr. Todd McDougle, Vince Rizzo  Non-Published Released Date Dec. 2015

(3) Chiropractic Care for Children

Lee, Anne CC, Dawn H. Li, and Kathi J. Kemper. “Chiropractic care for children.” Archives of pediatrics & adolescent medicine

154.4 (2000): 401-407.

(4) Dose-responsefor Chiropractic Care of Chronic Low Back Pain

Mitchell Haas, DCa, , , Elyse Groupp, PhDa,Dale F. Kraemer, PhDb a Center for Outcome Studies, Western States Chiropractic College, 2900 NE 132nd Avenue, Portland, OR 97230, USA b Department of Medical Informatics and Clinical Epidemiology, and Department of Public Health and Preventive Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA

Received 26 June 2003, Accepted 23 February 2004, Available online 9 September 2004

(5) Acute Ballistic Muscle Stretching Inhibits Maximal Strength Performance Arnold G. Nelson and Joke Kokkonen Research Quarterly for Exercise and Sport Vol. 72 , Iss. 4,2001

(6) Hox gene; From Wikipedia, the free encyclopedia

(7) Projections of Primary and Revision Hip and Knee Arthroplasty in the United States from 2005 to 2030 Steven Kurtz, PhD; Kevin Ong, PhD; Edmund Lau, MS; Fionna Mowat, PhD; Michael Halpern, MPH, MD, PhD J Bone Joint Surg Am, 2007 Apr; 89 (4): 780 -785 . https://doi.org/10.2106/JBJS.F.00222

(8) Advanced Peripheral Nerve Surgery and Minimal Invasive Spinal Surgery Volume 97 of the series Acta Neurochirurgica pp 7-12 TOS pathophysiology and clinical features Francesco Maria Crotti , A. Carai, M. Carai, N. Grimoldi, E. Sgaramella, W. Sias, F. Tiberio

(9)  Dunning J ,Mourad F ,Giovannico GMaselli FPerreault T ,Fernández-de-Las-Peñas C   PhD Student, College of Health Care Sciences, Nova Southeastern University, Ft. Lauderdale, FL. Electronic address: jamesdunning@hotmail.com. Journal of Manipulative and Physiological Therapeutics [2015, 38(6):382-394] Type: Evaluation Studies, Journal Article, Comparative Study DOI: 10.1016/j.jmpt.2015.06.008  {Notes Content}

(10) The T4 syndrome. DeFranca GGLevine LJ Journal of Manipulative and Physiological Therapeutics [1995, 18(1):34-37] {Slide Content}

(11) Revision Spine Surgery Management of iatrogenic flat-back syndrome

Gregory C. Wiggins, M.D., Stephen L. Ondra, M.D., and Christopher I. Shaffrey, M.D.

Neurosurgical Focus September 2003 / Vol. 15 / No. 3 / Pages 1-9

(12) Seyfer, Alan E., et al. “Upper extremity neuropathies after cardiac surgery.” The Journal of hand surgery 10.1 (1985): 16-19. Alan E. Seyfer. Author links open the author workspace. M.D.Opens the author workspaceNadja Y. Grammer. Author links open the author workspace. B.S.George P. Bogumill. Author links open the author workspace. Ph.D., M.D.John M. Provost. Author links open the author workspace. M.D.Usha Chandry. Author links open the author workspace. M.D. Plastic Surgery and Orthopaedic Surgery Services, Walter Reed Army Medical Center, Washington, D.C.

(13) Landry, Gregory J., et al. “Long-term functional outcome of neurogenic thoracic outlet syndrome in surgically and conservatively treated patients.” Journal of vascular surgery 33.2 (2001): 312-319.