Helping Hands Heal since 2005
From Dr. Z - Carpal tunnel syndrome specialist
Thoracic outlet syndrome exhibits symptoms very much like carpal tunnel syndrome. But they are very different disorders.
There are 5 key Thoracic Outlet Syndrome tests you can perform at home. They're the same tests you doctor will give you.
If you have symptoms like hand or finger pain, numbness and tingling you should perform these tests. They can tell if you have thoracic outlet syndrome versus carpal tunnel syndrome.
Thoracic outlet syndrome affects about 1 in 50 people. Carpal tunnel syndrome affects about 1 in 20. But because the symptoms of both can be nearly identical, doctors are often fooled into a wrong diagnosis. They suspect carpal tunnel when in reality the patient has thoracic outlet syndrome. Even worse, the doctor schedules carpal tunnel surgery. (And oops, the surgery doesn't work!)
This is why it's critically important for you to actually KNOW which condition you have. So if it's not thoracic outlet syndrome, then your symptoms are likely due to carpal tunnel syndrome. Follow the directions below.
The confusion between these two conditions is understandable. Symptoms of carpal tunnel and thoracic outlet both produce hand or finger pain, numbness, tingling, soreness, coldness, itching, and weakness.
However, each disorder is treated quite differently. So it’s important to know which condition you have in order to treat it successfully. After all, nobody wants to waste time and money following a treatment plan for the wrong condition.
Thoracic outlet syndrome is when nerves or blood vessels are compressed in the area near the armpit. Therefore, the symptoms of thoracic outlet syndrome depend on which of those structures are compressed.
When nerves are compressed, thoracic outlet symptoms include one or more of the following:
In contrast, when blood vessels are compressed as a result of thoracic outlet syndrome, the signs include one or more of the following:
The tests below are identical to what a doctor will give you for thoracic outlet syndrome. You can do these simple self-tests by yourself, but you need a partner to help.
There are tests your doctor can do for both carpal tunnel syndrome or thoracic outlet syndrome. Happily, you can also do these tests on yourself. I describe how to perform
self-tests for carpal tunnel syndrome here.
Below you will learn how to perform
self-tests for thoracic outlet syndrome. These tests are identical to those a doctor will give you. By doing these tests, you can eliminate thoracic outlet syndrome as the possible cause of your symptoms. Remember, you'll need a partner to help with the thoracic outlet syndrome tests below.
While seated or standing, raise both arms with elbows slightly behind your head. Then open and close your hands slowly for about 3 minutes.
A positive sign will be pain, heaviness or intense arm weakness or numbness, and perhaps tingling in your hand.
While you’re standing, the helper locates your radial pulse. That’s the pulse below your wrist crease on the thumb side. Then drop your arm at a 45 degree angle, and slightly behind you. Next, rotate your head toward the tested arm. Simultaneously tilt your head backwards to extend your neck as your helper extends and holds your arm to feel your pulse.
A positive sign will be disappearance of your radial pulse.
While you’re seated, the helper locates your radial pulse again, then draws your shoulder down and back as you lift your chest in an exaggerated “at attention” posture.
A positive sign is an absence of your radial pulse. This test is very effective in people who complain of symptoms while wearing a heavy jacket or back-pack.
While you’re seated, the helper locates your radial pulse again. They flex your elbow to 90 degrees while your upper arm is extended horizontally and rotated backward. You then turn your head away from the tested arm.
A positive sign is if your radial pulse disappears as your head is rotated.
Generally, this test is used if you already have obvious symptoms. While you’re seated, the helper grasps both arms by the elbows.
You must remain passive as the helper fully elevates your shoulders in a forward position. Hold this position for 30-60 seconds.
This activity will normally increase your pulse and your hand temperature.
A positive sign for thoracic outlet syndrome is when your arms, hands or fingers go from numbness to pins-and-needles (or tingling) as well as some pain. The positive sign is similar to what you might feel when your arm “falls asleep” and then circulation returns.
One or more positive signs in these 5 tests may mean you have thoracic outlet syndrome. There are many, good physical therapies and exercises you can do to correct the condition. In some cases, the symptoms cannot be reversed. However, in most cases, diligent effort will give you good results, with completely reversed symptoms of thoracic outlet syndrome.
