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Symptoms of thoracic outlet syndrome (TOS) can initially be mild and non-specific and patients typically to do not seek medical help until the intensity of the symptoms disturbs their day-to-day well being. The symptoms increase in frequency and severity and begin to affect the patient's job, sleep and general activities. When they do seek help, patients may find that they consult with several physicians who misdiagnose them because the determination of TOS is so difficult to confirm. Patients report that they are often told that their pain is psychosomatic and if an injury causing the TOS is employment related, health care providers dealing with workmen's compensation may minimize the injury and symptoms even further.

All of these difficulties often cause significant frustration and extract a significant psychological toll on patients. Quality of life in general and specific areas such as work and social life are severely compromised in some patients. Some patients develop emotional problems due to the lack of appropriate diagnosis and treatment and some may develop permanent neurological damage of the neural plexus because of the lag time before proper diagnosis. Depression is not uncommon among patients with TOS who may experience significant pain.

Depending on the severity of the individual case, thoracic outlet syndrome can be a lifelong condition which is usually controllable or manageable but is not curable and can have a significant impact not only on the patient but on family and friends as well. The condition affects many aspects of life to varying degrees, depending on the severity of the symptoms and the duration that the patient has suffered, including:

• Daily living activities
• Professional life
• Social life
• Personal life

Thoracic outlet syndrome may create a financial strain on the patient and their family due to reduced income from time lost at work, unemployment, and/or medical expenses which may be needed for patient care. Friends and family may find it beneficial to map out a plan of action with the patient's participation so that a daily routine is established. This reduces stress levels and minimizes unexpected changes of plan. Responsibilities that need to be addressed may include:

• Planning meals
• Cooking
• Cleaning
• Laundry
• Shopping
• Car pools
• Pet care
• Leisure activities (e.g., going to the library, movies)

Once the patient with TOS is correctly diagnosed, education about the condition and participation in treatment are essential. Posture awareness is considered one of the earliest hallmarks of successful rehabilitation. Avoiding postures and positions that exacerbate the symptoms requires concentration and behavior modification. Patients need guidelines for good standing, sitting, and sleeping positions. In addition, patients need to be counseled regarding modifications in the work place regarding physical layout, responsibilities, and any other related needs.

It is important for the patient with TOS to correct poor posture and to work on strengthening muscles in a timely fashion since over-correction or accelerated stretching of contracted muscles can exacerbate symptoms and cause further damage. Optimum range of motion in the thoracoscapular region (approximately mid-upper chest and back) is important in order to maintain correct posture.