First Rib Technique From Assessing and Treating Neurogenic Thoracic Outlet Syndrome: Neural compression of the brachial plexus is called neurogenic thoracic outlet syndrome (NTOS). These clients present with a variety of symptoms, including painless atrophy of intrinsic hand muscles and nighttime paresthesia. Athletes may have difficulty grasping a racquet or ball, and some report pain. However, I’ve found that rather than being the main pain event, NTOS is more of an enhancer of symptoms at a d