Treatment:
- Conservative treatment is always first approach (manual therapy, stretching of the neck and shoulder, and relaxation exercises)
- Vascular TOS generally requires surgical treatment and surgery usually involves decompression of the thoracic outlet with removal of the cervical rib (if present) and/or first rib excision together with associated muscles and other soft tissue structures as indicated
- Arterial TOS: surgery usually required due to structural lesion demonstrated