Thoracic Outlet Syndrome

Do you experience persistent neck and shoulder pain, tingling in your fingers, or weakness in your arms? These symptoms might not just be the result of a tough workout or a long day at work. They could point to a condition called Thoracic Outlet Syndrome (TOS). At Peak Performance in Buffalo, NY, we specialize in addressing musculoskeletal issues like TOS with evidence-informed chiropractic and massage care.


Let’s explore what TOS is, what causes it, how it’s treated, and how you can prevent it.



What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome is a group of disorders that occur when the nerves or blood vessels in the thoracic outlet—the space between your collarbone and first rib—become compressed. This compression can cause a variety of symptoms depending on which structures are affected.


Types of TOS:

  1. Neurogenic TOS: The most common type, involving compression of the brachial plexus (a network of nerves that controls muscle movements and sensations in your shoulder, arm, and hand).
  2. Venous TOS: Involves compression of the veins, potentially leading to swelling, discoloration, or blood clots in the arms.
  3. Arterial TOS: The least common type, caused by compression of the arteries, often leading to cold or pale fingers and weakened pulse in the arm.


Common Symptoms:



How Does Thoracic Outlet Syndrome Occur?

TOS develops when the thoracic outlet space becomes narrowed or constricted, leading to compression of nerves, veins, or arteries. Several factors can contribute to this, including:

  1. Poor Posture: Slouching or forward-head posture can reduce the space in the thoracic outlet, increasing pressure on the structures within.
  2. Repetitive Motion: Overhead activities or repetitive arm movements, such as typing or lifting, can strain the muscles and tissues around the thoracic outlet.
  3. Trauma: Injuries such as whiplash or clavicle fractures can lead to TOS by altering the anatomy of the thoracic outlet.
  4. Congenital Anomalies: Some individuals are born with extra ribs (cervical ribs) or other anatomical variations that predispose them to TOS.
  5. Athletic Activities: Sports that involve repetitive arm movements, such as swimming, baseball, or weightlifting, can increase the risk of developing TOS.




Treating Thoracic Outlet Syndrome

If you’re experiencing symptoms of TOS, it’s essential to seek professional evaluation. At Peak Performance in Buffalo, NY, we offer a range of treatment options tailored to your needs. Here’s how TOS is typically managed:


1. Chiropractic Care

Chiropractors can help by addressing postural imbalances and improving joint mobility in the neck, shoulders, and upper back. Treatments may include:


2. Massage Therapy

Massage therapy complements chiropractic care by targeting tight muscles and fascia around the thoracic outlet. Techniques such as trigger point therapy, myofascial release, and deep tissue massage can alleviate muscle tension and improve circulation.


3. Physical Therapy and Exercise

Strengthening and stretching exercises are vital for improving the function of the muscles that support the thoracic outlet. Common exercises include:


4. Lifestyle Modifications

Adjustments to your daily activities can help reduce symptoms. For example:


5. In Severe Cases

If conservative care doesn’t provide relief, more invasive interventions like corticosteroid injections or surgery may be necessary. Surgical options aim to remove the source of compression, such as a cervical rib or fibrous band.


Preventing Thoracic Outlet Syndrome

Preventing TOS is all about minimizing the risk factors that lead to compression of the thoracic outlet. Here are some practical tips to keep your thoracic outlet in top shape:


1. Prioritize Posture

Good posture is the foundation of a healthy musculoskeletal system. Focus on:


2. Ergonomic Adjustments

Ensure your workspace is set up to reduce strain:


3. Stay Active

Regular exercise helps maintain the strength and flexibility of the muscles supporting your thoracic outlet. Incorporate activities like yoga, Pilates, or swimming to promote mobility and stability.


4. Take Breaks

If your job involves repetitive arm or hand movements, take regular breaks to stretch and change positions. This helps prevent overuse injuries and muscle tension.


5. Listen to Your Body

Pay attention to any signs of discomfort or fatigue in your neck, shoulders, or arms. Addressing symptoms early can prevent them from worsening into a chronic condition.


Why Choose Peak Performance in Buffalo, NY?

At Peak Performance, we’re committed to providing evidence-informed care for conditions like Thoracic Outlet Syndrome. Our team of experienced chiropractors and massage therapists work together to develop personalized treatment plans that address the root cause of your symptoms. Whether you’re dealing with TOS caused by poor posture, a sports injury, or repetitive strain, we’re here to help.


Peak Performance offers a welcoming environment and a patient-focused approach. We believe in empowering our patients with the knowledge and tools they need to achieve long-term relief and optimal health.


Bethany Wolcott

D’Youville Chiropractic ‘26

By S21 GMB January 19, 2026
If you’ve ever dealt with back or neck pain, you’ve probably been told to “take pressure off the spine.” Easier said than done, right? That’s where a traction table comes in. Traction tables are a common, evidence-informed tool used in chiropractic offices to help reduce spinal compression, improve mobility, and relieve pain—without surgery or medications. Let’s break down what a traction table is, how it works, and who may benefit from incorporating traction into their care plan. 
By S21 GMB January 12, 2026
If you’ve ever wandered down the supplement aisle or scrolled past a wellness influencer, you’ve probably seen the words probiotic and prebiotic tossed around like everyone automatically knows what they mean. They sound similar, they’re often mentioned together, and yet they serve very different roles in your body. Understanding the difference between probiotics and prebiotics—and why both matter—can help you make smarter choices for digestion, immunity, inflammation, and even musculoskeletal health. Let’s break it down.
By Jun Sanchez January 5, 2026
Every January, the same thing happens. Gyms get crowded. Grocery carts fill with leafy greens. Water bottles reappear from the back of cabinets. And somewhere around mid-February… motivation quietly slips out the back door. If this sounds familiar, you’re not failing. You’re human. New Year’s resolutions get a bad reputation because so many of them don’t stick—but that doesn’t mean setting goals is pointless. It just means we need a better, kinder approach. One that focuses less on perfection and more on progress. Here’s how to make resolutions that feel doable, meaningful, and—most importantly—keepable. 
By Jun Sanchez December 29, 2025
Have you ever noticed back tension when you’re stressed, or neck stiffness that seems to flare up when you’re not feeling well? While it may seem coincidental, there’s a fascinating neurological explanation behind these patterns: the viscerosomatic reflex . Understanding the viscerosomatic reflex helps explain why internal organ dysfunction can show up as muscle tension, pain, or restricted movement—and why chiropractic and massage care can play a valuable role in managing these patterns. Let’s break it down. 
By Jun Sanchez December 24, 2025
Peak Performance Chiropractic & Wellness proudly hosted our Onederland Celebration , a festive, family-friendly event created to thank our patients, staff, and community for an incredible year of growth and support. The celebration brought together families, friends, and neighbors for an afternoon filled with holiday cheer, laughter, and meaningful connection. Guests enjoyed seasonal activities, treats, and special surprises while coming together for a greater purpose. The event also served as a toy drive benefiting Be A Blessing Buffalo , allowing attendees to give back and help bring joy to local families during the holiday season. The Onederland Celebration truly reflected what Peak Performance stands for—community, gratitude, and giving back. We are incredibly thankful to everyone who attended, donated, volunteered, and helped make this event such a success. Because of our amazing community, we were able to celebrate one year of growth while spreading kindness and making a positive impact beyond our walls. We look forward to continuing this tradition and creating even more meaningful moments together in the years ahead. 
By Jun Sanchez December 22, 2025
Understanding Fibromyalgia
By S21 GMB December 15, 2025
As temperatures drop and snow blankets the ground, winter sports enthusiasts eagerly prepare for a season of skiing, snowboarding, ice skating, and more. While these activities offer an exciting way to stay active during the colder months, they also present unique physical challenges that can lead to injuries if the body isn’t properly prepared. A strategic approach to seasonal wellness can help you build strength, improve flexibility, and reduce the risk of common winter sports injuries.
By S21 GMB December 8, 2025
When it comes to filling a stocking, there’s something magical about tiny treasures that pack a big punch. Sure, candy canes and fuzzy socks are classics—but what if your stocking stuffers could actually make someone feel better long after the holiday sugar crashes fade? This year, level up your gifting game with wellness-forward, feel-good, wow-that’s-so-useful ideas curated with your favorite chiropractic and massage office in mind. Whether you’re shopping for the gym buff, the “my neck hurts every day” coworker, the parent who needs a moment of peace, or that friend who swears they’re finally going to prioritize self-care in the new year, we’ve got you covered.  Here are our top stocking stuffers that are cute, practical, and chiropractor-approved.
By S21 GMB December 1, 2025
Thanksgiving is the time of year when we pause to appreciate the big things—family, food, football, and maybe even a perfectly flaky pie crust. But there’s one thing we often forget to be grateful for: our bodies . Every day, your muscles, joints, and connective tissues do a whole lot more than you realize. They carry you through grocery store marathons, marathon-marathons, late-night study sessions, workdays, workouts, and everything in between.  So this season, before you grab that second helping of mashed potatoes (no judgment here), take a moment to thank the parts of you that keep you moving. Here are five simple, meaningful ways to show your body a little gratitude—and feel better in the process.
By S21 GMB November 21, 2025
If you’ve ever stood up after a long day at your desk and thought, “Why does my lower back feel like it’s been personally offended?”—you’re not alone. In fact, your posture may be telling a whole story. Enter Lower Cross Syndrome (LCS) : a common postural pattern that shows up when certain muscle groups decide to overachieve while others go on vacation. The good news? You can absolutely fix it—and your favorite chiropractic and massage team is here to help.
Show More