What are the symptoms of thoracic outlet syndrome?

The nerves, arteries or veins passing from the lower neck toward the arm can become compressed. Nerve compression may produce pins and needles, reduced grip or aching around the neck, shoulder, arm or hand. Blood-vessel compression can make an arm feel heavy, cold or swollen, or cause the hand to look pale or bluish. Symptoms may increase when the arm is raised or held in one position. They can affect one side and may come and go.

These symptoms overlap with other causes of arm symptoms. The symptom pattern, examination and sometimes imaging or circulation tests help a clinician decide whether thoracic outlet syndrome is present. Read more about [Thoracic Outlet Syndrome](/conditions/thoracic-outlet-syndrome/), [Arm Numbness and Tingling](/symptoms/arm-numbness-and-tingling/) and [Hand Numbness](/symptoms/hand-numbness/).

Arrange an assessment if symptoms keep returning, interfere with reaching or gripping, or are accompanied by visible swelling or colour change. Note which activities bring them on, whether raising the arm changes them, and any loss of strength. Treatment may include activity changes, targeted exercises and [Physiotherapy](/treatments/physiotherapy-and-rehabilitation/physiotherapy/). A clinician may also discuss [Postural Correction Therapy](/treatments/physiotherapy-and-rehabilitation/postural-correction-therapy/) when shoulder or neck position contributes.

Seek urgent medical care for sudden or marked arm swelling, a blue or very pale hand, severe coldness, rapidly worsening weakness, or chest discomfort or breathing difficulty. These features can signal an urgent circulation or nerve problem and should not wait for a routine appointment.

Could my symptoms involve a nerve, artery or vein? Which examination or test would clarify the cause? Should I change any work, exercise or sleeping position while waiting? What symptoms would require immediate review?