Diagnosis of TOCS
TOCS is difficult to diagnose because a number of other conditions can cause similar symptoms. To get an accurate diagnosis, a thorough patient history and review of symptoms will be conducted.
Common symptoms of TOCS include:
- Pain in the neck, shoulder and arm
- Weakness, coldness and/or numbness in the fingers
- Reduced sensation of touch
- Swelling in the arms
- Ache in the side and back of the head that extends to the chest area
- Reduced function of the shoulder, arm and hand
In neurogenic TOCS, different symptoms can present, depending on the location of nerve compression:
- Compression of the upper brachial plexus may cause symptoms in the side of the head and neck, including the ear, jaw, face, temple and back of the head. Upper plexus compression may affect the forearm and arm, but not the hand.
- Lower plexus compression tends to affect the arm and hand. You may experience some numbness or tingling in the ring and little fingers.
Ultrasound provides a reliable means of diagnosing TOCS when combined with testing and patient history. Tests include assessments of muscle strength and arm sensation, with the arm held in neutral positions and in positions where the patient experiences maximal symptoms.
Treatment for TOCS
Physical therapy is the most effective way to resolve TOCS. Your therapist is likely to take a multi-modal approach to treatment, including:
- Strengthening exercises for the muscles that support the collarbone
- Exercises and training to correct postural issues, to reduce pressure on the nerves and blood vessels
- Lifestyle modification, including weight loss, workplace ergonomics and increased physical activity
- Sport-specific rehab training for athletes
In rare cases, surgery may be required to reduce compression. Surgical interventions sometimes involve the removal of a rib or releasing the scalene muscles that join the neck and head.
TOCS Treatment at NYDNRehab
The physical therapy team at NYDNRehab takes a holistic whole-body approach to diagnosis and treatment. We understand that your symptoms are unique to you and your lifestyle, and we treat every patient on a case-to-case basis. At NYDNRehab, we use cutting-edge technologies and advanced treatment methods to get to the source of your pain and resolve it. If you are experiencing symptoms of TOCS, contact NYDNRehab for a quick and accurate diagnosis, and an individualized treatment plan.