Thoracic Outlet Syndrome Treatment Guideline

Draping and Pillowing

  • Regular
  • pillow under legs
  • Check in on comfort


  • Heat to scalenes, pectoralis minor and posterior shoulder

Specific Treatment

  • Decrease tone in scalenes
    • Work on trigger points, negotiate trigger point work
  • Decrease tone in pec minor
    • Trigger point work. Negotiate
  • If edema present, elevate
  • Focus on neck and chest

Joint Mobilization

  • Shoulder
  • Clavicle
  • Sternum
  • State grade 1 or 2 and oscillation


  • Check in throughout with client about comfort
  • Ask if symptoms are getting worse
  • Negotiate trigger point work
  • Negotiate connective tissue work

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