Thoracic outlet syndrome (TOS) often mimics carpal tunnel syndrome, with symptoms like hand pain, numbness, or tingling in the fingers. But while the two conditions can feel nearly identical, they’re actually very different—and require completely different treatments.

Fortunately, there are five simple tests you can perform at home to help determine if you have thoracic outlet syndrome. These are the same tests your doctor would use during an examination. If your symptoms include hand weakness, tingling, or shooting pain down your arm, these tests can help you uncover whether the real problem starts in your neck and rib area (as it does with TOS), rather than in your wrist.

Thoracic outlet syndrome affects about 1 in 50 people, while carpal tunnel syndrome affects about 1 in 20. Because their symptoms overlap, even experienced physicians can mistake one for the other—and that can lead to unnecessary carpal tunnel surgery that doesn’t solve the problem.

That’s why it’s so important to understand the difference yourself. The information and tests below will help you determine whether your symptoms come from thoracic outlet syndrome—or if they’re more consistent with carpal tunnel syndrome. Knowing which one you truly have is the first step toward getting the right treatment and lasting relief.

• Think you have carpal tunnel? Complimentary self-test

• Already know you have carpal tunnel? Learn how severe your symptoms are with this Quiz

Anybody can develop thoracic outlet syndrome. However, women (especially those around age 40) are most prone to this disorder. Also at risk are individuals who have poor posture, a history of neck or shoulder injury, and those who perform repetitive overhead arm movements.

Other risk factors include being overweight, congenital anatomical differences like a cervical rib, and trauma, such as whiplash. 

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:

• Muscle degeneration in your thumb's fleshy base
• Numbness or tingling (pins & needles) in your fingers, hand or arm
• Aches and pains your hand, shoulder or neck
• Weak grip strength

In contrast, when blood vessels are compressed as a result of thoracic outlet syndrome, the signs include one or more of the following:

• Hand discoloration (bluish color)
• Arm swelling and pain
• Blood clot in arteries or veins in the upper body area
• Loss of color in one or more fingers (sometimes the entire hand)
• Weakened pulse in the affected arm
• Cold arms, hands or fingers
• Fatigue with physical activity in the affected arm
• Numbness or tingling (pins & needles) in one or more fingers
• Weakness in the neck or arm
• A lump near your collarbone that throbs

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. 

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.

Is it possible to have thoracic outlet syndrome and carpal tunnel syndrome at the same time?

Yes. Having both disorders is more commonly seen women with poor posture.

What if one test is positive but the rest are not?

You should repeat the positive test multiple times to ensure you get the same results. Generally, two or more tests with positive results indicate thoracic outlet syndrome. But if any single test is positive, see your doctor.

What can be done for thoracic outlet syndrome?

Usually a program of stretching exercises will help a great deal. More severe cases may require surgery.