Tingling in the arm and hands or paresthesia can have many causes, one very common cause is Thoracic Outlet Syndrome (TOS). The most common symptoms associated with TOS are pain, tingling, and weakness in the hand, arm, and shoulder, plus neck pain and occipital headaches.  Hand coldness and color changes are also seen associated with this condition.

There are three types of TOS; arterial, venous and neurogenic.  According to a study (1) published in the Journal of Vascular Surgery, 90% of TOS are of the neurogenic etiology.  The cause of neurogenic TOS is most commonly compression of the nerves that exit the neck and run down the arm into the hand.  This is similar to sitting cross-legged, which puts pressure on the nerves and causes tingling.

Diagnosis of this condition involves a complete physical work up including in most cases x-rays.  If the diagnosis of TOS is made, the focus of treatment is to restore the normal range of motion in the neck, relieve the compression in the neck and provide stretches and exercises to prevent the return of this condition.  This is something that we see very often in our office and can go undiagnosed or misdiagnoses leading to expensive and potentially risky medical procedures.

1. Diagnosis of thoracic outlet syndrome. Journal of Vascular Surgery; Volume 46, Issue 3, September 2007, pages 601-604