Nerves for the arm exit the lower vertebrae in the neck between two muscles on each side called the scalenes. From there, the nerves and blood vessels pass under the clavicle -- or collar bone -- and pass along the ribs toward the shoulder. These nerves and blood vessels can be pinched by the scalene muscles or by a narrowing of the tunnel under the clavicle, causing the symptoms called thoracic outlet syndrome.
Symptoms
The common symptoms of thoracic outlet syndrome are coldness in the upper arm or chest, fatigue in the arm and shoulder, plus numbness, weakness, pain, swelling and tingling typically felt in the arm or hand, according to Cedars-Sinai Hospital. The problem usually affects one side of the body. If the nerves aren't pinched by the scalene muscles, then the cause may be a narrow outlet under the clavicle because of an extra first rib or an old fracture. Work that involves raising your arms a lot or holding them overhead, poor posture and weak shoulder muscles can also contribute to thoracic outlet syndrome.
Treatment
Conservative treatment includes reducing the amount of time you work with your arms overhead, avoiding carrying heavy bags on your arm or over your shoulder and improving your posture. Your doctor may recommend over-the-counter pain medicine in addition to rest. Exercises that improve your posture and strengthen the shoulder muscles that support the clavicle will help as will stretching neck and shoulder muscles.
Exercises for the Neck and Shoulders
While standing, lift your shoulders up and back, as if you are trying to squeeze them behind your neck. Hold the tension for five seconds and then relax and drop your shoulders. Repeat up to five times.
Looking straight ahead, pull your chin into your neck as if you are trying to make a double chin. Hold the tension for five seconds and then relax. Repeat up to five times.
Looking straight ahead, drop your shoulders. Bending your neck to one side, try to touch your right shoulder with your right ear, until you feel a good stretch in the left side of your neck. Hold the tension for five seconds and repeat up to five times. Then try to touch your left shoulder with your left ear, stretching the right side of your neck.
Upper Chest and Shoulders
Stand facing a corner of the room. Place one hand on each wall at elbow height. Keeping your body straight, lean your chest into the corner until you feel a stretch across the upper chest. Hold the stretch for five seconds and repeat up to five times. Then place your hands on the walls at shoulder level and repeat. Finally place your hands on the walls at the same height as your head and repeat the exercise.
Standing, clasp your hands behind your back and squeeze your shoulder blades together in the back. Breathe in, and keep your chin in. Relax and repeat up to five times.
Sitting, clasp your hands behind your head. Try to move the points of your elbows up toward the ceiling and back. Don't push your head forward, keep it in line with your spine.
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