Seeking Compensation for Work-Related Thoracic Outlet Syndrome

Thoracic Outlet Syndrome is a painful and often debilitating condition that can arise from certain workplace activities. This short guide provides an overview of the condition, common occupational causes, and the steps you can take if you believe your employer’s negligence contributed to its development.

What is Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is caused by compression of the nerves, arteries, or veins in the thoracic outlet, the space between the collarbone and first rib. This compression can result from anatomical abnormalities, repetitive movements, trauma, or poor posture, and it often affects individuals who perform overhead activities regularly, such as athletes or manual labourers. The syndrome is classified into three types: neurogenic, venous, and arterial, with neurogenic TOS being the most common, involving pressure on the brachial plexus nerves.

Symptoms vary depending on the type but may include pain, numbness, tingling, weakness in the shoulder, arm, and hand, and swelling or discolouration in cases involving vascular compression. Diagnosis involves physical examinations, imaging studies, and nerve conduction tests. Treatment ranges from physiotherapy and pain management to surgical intervention in severe cases, to relieve pressure on the affected structures and restore normal function.

What are the consequences of TOS for a person diagnosed with it?

In the most severe cases of Thoracic Outlet Syndrome, individuals may experience significant and lasting impairment. Chronic nerve compression can lead to muscle wasting, particularly in the hand, along with persistent pain, weakness, and loss of coordination, severely affecting daily activities and quality of life. If the vascular forms of TOS are left untreated, there is a risk of serious complications such as blood clots, aneurysms, or even stroke due to compromised blood flow.

In rare instances, severe TOS can result in permanent nerve damage or limb-threatening conditions if circulation is severely restricted. Surgical intervention, while often effective, carries several risks and may not fully resolve symptoms in every case.

What sort of work-related activities can cause TOS?

There are a multitude of workplace activities or incidents that can contribute to or directly cause the development of Thoracic Outlet Syndrome. This includes the following:

• Repetitive overhead work – Tasks such as painting, electrical work, or stocking shelves require frequent lifting of the arms, which can compress nerves and vessels in the thoracic outlet.
• Heavy lifting – Carrying or lifting heavy loads, particularly on the shoulders (e.g. construction work or warehouse jobs), can strain the neck and shoulder region.
• Poor ergonomic posture – Desk jobs with improper chair or monitor height can lead to slouched posture, contributing to muscle tightness and nerve compression.
• Prolonged typing or computer use – Continuous use of a keyboard or mouse without breaks can strain the neck, shoulders, and upper chest muscles.
• Vibration exposure – Using tools like jackhammers or power drills for long periods can cause muscle fatigue and inflammation around the thoracic outlet.
• Repetitive assembly line work – Factory jobs that involve repeated arm and shoulder movements can increase the risk of nerve entrapment.
• Neck or shoulder trauma – Workplace accidents such as slips, falls, or whiplash injuries can alter anatomy or create swelling that compresses nearby structures.
• Backpack or toolbelt use – Wearing heavy backpacks or toolbelts for extended periods may apply downward pressure on the shoulders, narrowing the thoracic outlet space.

What should employers do to prevent these types of issues?

Employers have a legal duty under the Safety, Health and Welfare at Work Act 2005 to ensure, so far as is reasonably practicable, the safety, health, and welfare of their employees. This includes taking proactive steps to prevent work-related conditions like TOS. Employers must identify potential risks in the workplace, particularly those linked to repetitive tasks, poor posture, manual handling, or the use of tools that could contribute to musculoskeletal disorders.

To meet their obligations, employers must carry out regular risk assessments, implement ergonomic solutions, and provide appropriate training and information to employees on safe work practices. Where necessary, they should also offer adjustments to workstations, enforce regular breaks, and rotate tasks to reduce strain. The Health and Safety Authority provides guidance and may inspect workplaces to ensure compliance. Failure to uphold these duties can result in enforcement actions, including fines or prosecution.

What should I do if I believe my employer failed to meet its obligations?

If you have been diagnosed with TOS, and you believe negligence by your employer played a significant role in its development, there are several important steps to consider.

1. Secure medical documentation – First, ensure you have a clear medical diagnosis and supporting documentation linking your TOS to your work activities. A specialist or occupational health professional can help establish this connection.
2. Report the issue – Inform your employer in writing about your condition and your belief that it is work-related. This creates a record and allows them to respond or make changes.
3. Review internal procedures – Check if your workplace has a formal process for reporting health and safety concerns, injuries, or workplace-related illnesses. Use it to log your concerns officially.
4. Contact the Health and Safety Authority – If you believe your employer is not taking appropriate action or has breached their legal obligations, you can report the matter to the HSA, which may investigate.
5. Seek legal advice – Consult with a solicitor who specialises in personal injury law. You may have grounds to claim compensation if negligence can be proven.
6. Keep records – Maintain a detailed record of your symptoms, any work-related tasks that aggravate them, correspondence with your employer, medical appointments, and treatments received.

How is it possible to prove employer negligence?

Proving employer negligence involves demonstrating a clear link between your condition and unsafe or unsuitable working conditions that your employer failed to address. This generally requires a combination of medical evidence, workplace documentation, and legal expertise.

A medical expert can provide a professional opinion stating that your TOS is consistent with the type of work you were doing – particularly if it involved repetitive strain, poor ergonomics, or physical stress. You’ll also need to show that your employer breached their duty of care. This might involve evidence such as lack of proper training, failure to provide ergonomic equipment, ignoring complaints or symptoms, or not conducting risk assessments. Witness statements, workplace photos, health and safety records, and prior reports of similar issues can also strengthen your case.

How can a solicitor help?

A personal injury solicitor will help you by guiding you through the legal process of making a claim, ensuring your case is properly presented and your rights are protected. They will begin by assessing the strength of your claim, reviewing your medical evidence, workplace conditions, and any documentation that supports the link between your Thoracic Outlet Syndrome and your employment.

Solicitors handle the legal procedures on your behalf, including gathering additional evidence, liaising with medical experts, and negotiating with the employer’s insurance company. They can help you with the Injuries Resolution Board’s claims process, ensuring the claim is submitted properly and without errors, and, if needed, they can represent you in court. Your solicitor will aim to secure fair compensation for your pain and suffering, lost earnings, medical expenses, and any impact on your ability to work in the future.

Require assistance bringing a claim?

If you have been diagnosed with Thoracic Outlet Syndrome, and you believe employer negligence played a significant role in its development, arrange a time to speak with an experienced personal injury solicitor here at McCarthy + Co Solicitors LLP. Simply send us a message using our secure and confidential online form, and a member of our team will get back to you.