Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) involves a whole group of disorders that can occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. This usually causes shoulder pain, neck pain, and numbness in the fingers.

There are three general types of thoracic outlet syndrome:

  • Neurogenic (neurologic) thoracic outlet syndrome(most common type):  Neurogenic thoracic outlet syndrome gets characterized by the compression of the brachial plexus. Doctors define the brachial plexus as the network of nerves that give movement and feeling in the arms and hands.
  • Venous thoracic outlet syndrome. Occurs when one or more of the veins under the collarbone (clavicle) are compressed, resulting in blood clots.
  • Arterial thoracic outlet syndrome. The least common type of TOS. It occurs when one of the arteries under the collarbone is compressed, resulting in the bulging of the artery, also known as an aneurysm.

It’s possible to have a combination of the three different types of thoracic outlet syndrome, with multiple parts of the thoracic outlet being compressed.

Physical trauma from car accidents, wear and tear injuries from repetitive motions involved with work or sports activities, certain defects such as having an extra rib, and pregnancy. Some cases don’t present an obvious cause of thoracic outlet syndrome.

Treatment for TOS usually involves physical therapy and pain relief measures. Most people improve with only these conservative treatments. In some cases, however, your doctor may recommend surgery.

What are the symptoms of thoracic outlet syndrome?

  • Shoulder pain
  • Neck pain
  • Numbness in the fingers

The symptoms of Thoracic outlet syndrome vary in the different types:

Neurogenic thoracic outlet syndrome symptoms:

  • Numbness or tingling in your arm or fingers
  • Pain or aches in your neck, shoulder, arm, or hand
  • Weakening grip

Venous thoracic outlet syndrome symptoms:

  • Discoloration of your hand (blue in color)
  • Pain and swelling of the arm
  • Blood clots in veins in the upper area of your body
  • Arm fatigue with activity
  • Paleness or abnormal color in one or more fingers or your hand
  • Throbbing lump near your collarbone

Arterial thoracic outlet syndrome symptoms:

  • Cold fingers, hands, or arms
  • Hand and arm pain
  • Lack of color (pallor) or bluish discoloration (cyanosis) in one or more of your fingers or your entire hand
  • Weak or no pulse in the affected arm

What are the causes of thoracic outlet syndrome?

The compression of the nerves or blood vessels in the thoracic outlet, just under your collarbone (clavicle) typically causes thoracic outlet syndrome. The cause of the compression varies and can include:

  • Anatomical defects: Inherited defects that are present at birth (congenital) may include an extra rib located above the first rib (cervical rib) or an abnormally tight fibrous band connecting your spine to your rib.
  • Poor posture: Compression in the thoracic outlet area can occur from drooping your shoulders or holding your head in a forward position.
  • Trauma: Car accidents and other traumatic events, can cause internal changes that then compress the nerves in the thoracic outlet. The onset of symptoms related to a traumatic accident often is delayed.

If you or a loved one is suffering from thoracic outlet syndrome, contact Nextgen Wellness Group today. Our pain management specialists can help you take the first steps in healing.

Our mission is to help patients to return to work, improve their quality of life, reduce dependence on medication and healthcare providers, and avoid persistent injuries.

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