What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome is a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed.

This can cause pain in your shoulders and neck and numbness in your fingers.

This condition involves compression of the brachial plexus – nerves exiting the neck that supply the arm – at one or more of three common locations.

The brachial plexus exits the spine out the side of the neck and travels through muscles here.

It then travels under the collar bone, then under muscles in the front of the shoulder and chest.

Common causes of thoracic outlet syndrome:

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

·       Poor posture. Drooping your shoulders or holding your head in a forward position can cause compression in the thoracic outlet area.

·       Repetitive activity. You may notice symptoms of thoracic outlet syndrome if your job requires you to repeat a movement continuously, such as typing on a computer, working on an assembly line or lifting things above your head, as you would if you were stocking shelves.

·       Pressure on your joints. Obesity can put an undue amount of stress on your joints, as can carrying around an oversized bag or backpack.

·       Pregnancy. Because joints loosen during pregnancy, signs of thoracic outlet syndrome may first appear while you’re pregnant.

 *Athletes, such as baseball pitchers and swimmers, also can develop thoracic outlet syndrome from years of repetitive movements.

·       Trauma. A traumatic event, such as a car accident, 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.

Symptoms:

Thoracic outlet syndrome symptoms can vary, depending on which structures are compressed. When nerves are compressed, signs and symptoms of neurological thoracic outlet syndrome include:

• Muscle wasting in the fleshy base of your thumb (Gilliatt-Sumner hand)
• Numbness or tingling in your arm or fingers
• Pain or aches in your neck, shoulder or hand
• Weakening grip

Treatment:

Treatment for thoracic outlet syndrome typically consists of massage, physical therapy and medication.

Surgery may be needed if symptoms don’t improve after initial treatment.

Complications:

If your symptoms haven’t been treated early, you may experience progressive nerve damage, and you may need surgery.

Doctors recommend surgery to treat thoracic outlet syndrome only when other treatments haven’t been effective.

Surgery has higher risks than do other treatments and may not always treat your symptoms.

Prevention:

Thoracic outlet syndrome that goes untreated for years can cause permanent neurological damage, so it’s important to have your symptoms evaluated and treated early, or take steps to prevent the disorder.

If you’re susceptible to thoracic outlet compression, avoid repetitive movements and lifting heavy objects.

Even if you don’t have symptoms of thoracic outlet syndrome, avoid carrying heavy bags over your shoulder, because this can increase pressure on the thoracic outlet.

To help prevent or alleviate symptoms of TOS…

Stretch daily, and perform exercises that keep your shoulder muscles strong & get regular massage from a skilled therapist.