Thoracic Outlet Syndrome

The thoracic outlet is the area of the lower neck and upper chest. This area has a variety of nerves, blood vessels, muscles and bones that run through a fairly small area. When the nerves and blood vessels of this area are compressed, irritated or injured they can cause a range of symptoms known as the thoracic outlet syndrome (TOS).

  • Causes

    Compression, injury, or irritation of nerves and blood vessels can be caused by:

    • Defects in nearby structures
    • Poor posture
    • Trauma
    • Repetitive arm or shoulder movement
    • Tumors

  • Definition

    The thoracic outlet is the area of the lower neck and upper chest. This area has a variety of nerves, blood vessels, muscles and bones that run through a fairly small area. When the nerves and blood vessels of this area are compressed, irritated or injured they can cause a range of symptoms known as the thoracic outlet syndrome (TOS).

    Thoracic Outlet Syndrome
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  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.

    During an elevated arm stress test, your doctor will ask you to hold your arms and head in positions that may cause the TOS symptoms to reappear. The results of these tests will help determine whether you have TOS and rule out other possible related conditions.

    Other tests may include:

    • Blood tests
    • Electromyography and nerve other conduction tests

    Images of internal body structures may be taken with:

    • Chest x-ray
    • Ultrasound
    • CT angiography
    • MRI scan
    • Venography

  • Prevention

    There are no current guidelines to prevent TOS.

  • Risk Factors

    Factors that may increase your chance of developing TOS include:

    • Having an abnormal first rib
    • Poor posture
    • Repetitive motion
    • Trauma
    • Obesity

  • Symptoms

    TOS may cause the following:

    • Arm or hand pain
    • Arm or hand weakness
    • Numbness and tingling
    • Cold sensitivity in the hands and fingers
    • Pain or sores of the fingers
    • Poor blood circulation to the arm, hands, and fingers
    • Swelling of the limb
    • Skin of arm turning pale and blue

  • Treatment

    Treatment varies depending on your specific symptoms. In most cases, TOS is managed with pain medication and physical therapy.