Thoracic Outlet Syndrome

Thoracic outlet syndrome refers to a group of disorders that compress nerves or blood vessels in the space between the collarbone and the first rib (the thoracic outlet). Thoracic outlet syndrome leads to shoulder and neck pain and numbness in the fingers.


Nerves and blood vessels in the thoracic outlet can be injured in a number of ways, including trauma from a car accident, sports or job-related injuries caused by repetitive motion, pregnancy, and birth defects (e.g. an extra rib). In some people, the cause of thoracic outlet syndrome is unknown.


There are three types of thoracic outlet syndrome. Neurogenic is the most common and affects the nerves, causing pain and tingling in the neck, shoulder, arm, and hand. Venous affects the veins and causes blood clots. Arterial is the least common and causes bulging of the artery, which is also known as an aneurysm. It is possible to have a combination of the different types of thoracic outlet syndrome.


Diagnosing the exact type of thoracic outlet syndrome can be challenging because the severity and symptoms vary widely. Physicians will assess your medical history and ask questions about your symptoms. A physical exam will also identify external signs, such as discoloration, swelling, limited range of motion, and abnormal pulses. Imaging and nerve tests may also be required to confirm the diagnosis.


Treatment options for thoracic outlet syndrome vary widely and usually depend on the type of disorder. Most people will benefit from medications to control pain or inflammation, as well as physical therapy. Clot-dissolving medications may be administered in the veins to dissolve blood clots from venous or arterial thoracic outlet syndrome. If conservative treatments are not effective, surgery could be required.

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