With the change of people’s work habits, most white-collar work, lack of exercise, people always have cold neck and shoulder. After a long time, some people will have neck and shoulder pain or soreness, accompanied by pain and soreness in the upper limb or elbow joint, and weakness in the affected limb. These people feel uncomfortable even when they sleep with the affected limb, and some of them may have dizziness and tinnitus. Some of these people, who have been seen several times in several hospitals, have had shoulder joint films, cervical spine films and other related examinations; these results did not show any obvious abnormalities, and some of them were diagnosed as early stage of cervical spondylosis, early stage of frozen shoulder, cervical myofasciitis and so on. The treatment effect is not good, and the pain and soreness affect work and life. In fact, the disease they suffered from was neurogenic thoracic outlet syndrome. The disease, also known as superior trunk thoracic outlet syndrome, is a condition in which the cervical 5 and 6 nerve roots at the exit intervertebral foramen are encircled by the tendonous starting fibers of the crossed anterior and middle oblique muscles, and can also be caused by aseptic inflammation of the neck-related muscles leading to muscle group spasm, which in turn traps the corresponding nerves and triggers painful symptoms in the neck, shoulder and arm. In almost all cases, there is pressure pain at the midpoint of the posterior border of the sternocleidomastoid muscle or at the oblique angle muscle, and in half of the cases, there is pressure pain at the medial superior scapular angle. Electromyography is positive in only a minority of patients. Radiographic radiographs of the cervical spine show significant hyperplastic changes and narrowing of the intervertebral space in about 70% of cases and 50% of cases in the latter; in addition, about 1/3 of cases show loss of the physiological curvature of the cervical spine, straightening and excessive transverse processes; in another 10% of cases, cervical ribs and anterior border of the vertebral body may show bird’s beak-like bone hyperplasia. The majority of cases may have no abnormalities. Past history Most patients have a long history of neck and shoulder pain and are treated as cervical and shoulder disease or frozen shoulder. Nearly half of them were misdiagnosed as cervical spondylosis, and another 2/5 patients were misdiagnosed as frozen shoulder and shoulder impingement.