Compressed nerves or vessels near the collarbone
Thoracic outlet syndrome (TOS) is compression of the nerves or blood vessels passing through the space between the collarbone and first rib, producing arm pain, numbness, and weakness. Same-day or next-week evaluations across eight LA-area offices.
Board-certified surgeons and podiatrists across eight Los Angeles area neighborhoods.
Key takeaways
Thoracic outlet syndrome (TOS) is compression of the nerves or blood vessels passing through the space between the collarbone and first rib, producing arm pain, numbness, and weakness. Symptoms can develop gradually or after a specific injury, so early evaluation matters when function starts to decline.
Most people with thoracic outlet syndrome have the nerve (neurogenic) type, which usually improves with conservative care: physical therapy focused on posture, stretching of the tight neck and chest muscles, and shoulder-blade strengthening, along with activity changes. Injections into the scalene muscles are sometimes used to confirm the diagnosis or ease symptoms. The less common blood vessel types, which can cause arm swelling, color change, or a cold hand, need prompt vascular evaluation and are more often treated with surgery. If an arm suddenly becomes swollen, blue, pale, or cold, go to the emergency room, because this can mean a blood clot or a blocked artery.
Below, we walk through the anatomy involved, the symptoms and causes we most often see, how we diagnose thoracic outlet syndrome, and the full range of treatment options, from the simplest to the most involved.
This is a label given to a group of disorders. In these disorders, nerves or blood vessels are compressed in the space between your collarbone and the underlying rib. This space is called the "thoracic outlet."
The shoulder is the most mobile joint in the body, which makes it vulnerable to instability and impingement. The elbow is a hinge that lets you reach, lift, and rotate the forearm. Both rely on tendons and ligaments that can tear or fray over time.
You want answers, fast, and we're built to give them. Most patients leave their first LAOSS visit with a clear diagnosis and a written plan, not another referral chain.
Here's what your initial visit for thoracic outlet syndrome typically looks like:
Schedule your evaluation at the LAOSS office nearest you.
Once we've confirmed the diagnosis, the next step is matching the right treatment to your situation. We start with the least-invasive option that fits, and escalate only when it doesn't.
Non-surgical options designed to relieve pain, restore movement, and avoid the OR when possible.
Surgery is considered when symptoms persist despite therapy, or when a blood vessel is compressed. These operations are usually performed by a vascular or thoracic surgeon.
Shoulder & elbow care is highly technique-dependent. Volume, training, and judgment together determine the outcome you actually feel six months later.
Our shoulder & elbow specialists move stepwise: start with the least-invasive option that fits your situation, escalate only when it doesn't.
If most of these match your situation, an evaluation with a shoulder & elbow specialist is the next step.
These signs typically point toward an in-person evaluation with a shoulder & elbow specialist.
Your first visit is built to give you an answer the same day, not just another referral.
ImportantSeek urgent evaluation for sudden severe pain, numbness, progressive weakness, a suddenly swollen, cold, pale, or blue arm or hand (go to the emergency room right away, since this can mean a blood clot or blocked artery), or any sign of infection (fever, increasing redness or swelling).
Recovery is rarely a straight line, but a clear plan with measurable milestones makes the path predictable.
In the first two weeks we focus on protecting the shoulder & elbow, calming inflammation, and restoring basic motion.
Targeted physical therapy rebuilds strength, mobility, and confidence in the shoulder & elbow.
Once function is restored, the focus shifts to keeping you there, and catching any recurrence early.
We talk through the risks and benefits with every patient. Informed consent is a conversation, not a form.
Every orthopedic intervention carries a small set of standard risks. We screen, prepare, and monitor for these on every patient.
Some risks are tied to the structures we're treating in the shoulder & elbow. We discuss these in detail at your visit so you can weigh them against the benefits.
At LAOSS, our shoulder & elbow specialists are board-certified and treat these problems every day. From minimally invasive arthroscopic techniques to joint replacement and arthritis management, our physicians bring decades of experience to every case. We have cared for Los Angeles patients since 2007, with one goal for each: less pain, better movement, and a return to the activities you love.
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Shoulder & Elbow Surgeon
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Total Joint & Sports Medicine
Don't let thoracic outlet syndrome be something you just power through. With same- or next-day appointments at multiple Los Angeles locations, you'll never wait weeks or months for answers. The same team handles your diagnosis, treatment, and recovery. Whether you need physical therapy, injections, or surgery, we plan it with you and coordinate each step.
Call or schedule online today to see a shoulder & elbow specialist in Los Angeles.
Book a visit with a shoulder & elbow specialist at any of our eight Los Angeles-area offices.
