CTVS: Condition Page — Thoracic Outlet Syndrome
What is Thoracic Outlet Syndrome?
Thoracic Outlet Syndrome (or TOS) occurs when the blood vessels and nerves in between your collarbone and upper ribs (or thoracic outlet) become compressed, causing pain, numbness or tingling along the neck, shoulders, arms, and fingers.
There are two types of TOS:
- Neurogenic thoracic outlet syndrome involves compressed or pinched nerves, and it is the most common form of TOS.
- Vascular thoracic outlet syndrome occurs when the blood vessels or arteries are pinched.
TOS can result from any type of physical trauma from whiplash in a car to repetitive or overuse injuries in sports, like baseball.
If not treated properly, TOS can result in permanent nerve damage or a blocked artery which can be very serious.
What are the symptoms of Thoracic Outlet Syndrome?
TOS can sometimes be difficult to diagnose because its symptoms share characteristics of many other conditions such as rotator cuff or cervical disc injuries, fibromyalgia, or multiple sclerosis.
Common symptoms of Thoracic Outlet Syndrome include:
- Numbness, pain, heaviness, or tingling in the shoulder, arms, hands or fingers
- Sudden aches or pains in neck or shoulders
- Weakened grip
- Discoloration of hand or fingers (typically blue or purple)
- Weakened pulse
- Throbbing lump or sensation in the upper chest near the collarbone
Diagnostic tests that may help confirm TOS are blood tests, X-rays to view bone health, an EMG (electromyography) to measure muscle strength, or an MRI to check for arterial blockages.
What are the risk factors for Thoracic Outlet Syndrome?
TOS is most commonly diagnosed in women who are between 20 and 50 years of age. Risk factors that might contribute to TOS are:
- Traumatic injuries
- Anatomical defects in the neck or chest
- Tumors in the neck or chest
- Poor posture over a long period of time
- Pregnancy as excess pressure is put on the entire body
- Repetitive arm and shoulder movements or activity, such as from playing certain sports like tennis or golf
How is Thoracic Outlet Syndrome treated?
If you experience symptoms of TOS for several days, seek medical attention. To relieve symptoms of most cases of TOS, treatment might include:
- Physical therapy with targeted exercises to strengthen chest muscles and improve posture
- Non-steroidal anti-inflammatory medications
- Thrombolytics to break up and prevent blood clots
- Muscle relaxers
In severe cases, thoracic outlet decompression surgery may be necessary to relieve pressure on the affected area of the chest.
Our board-certified thoracic and vascular surgeons at CTVS who specialize in treating TOS are:
David A. Nation