Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) refers to the condition characterized by swelling, pain, or other symptoms resulting from compression in the thoracic outlet, which is the narrow passage between the upper chest and lower neck. This compression can lead to tingling and numbness in the shoulders, particularly when raising the arms.

The thoracic outlet is the space between the collarbone and top ribs, through which muscles, nerves, and blood vessels extend from the neck to the shoulder and down the arm. When pressure is applied to these structures, it can cause pain and other symptoms.

There are different types of Thoracic Outlet Syndrome:

  1. Neurogenic TOS: Involves compression of the nerves that run from the spinal cord to the neck and arm. Most cases of Thoracic Outlet Syndrome are of this type and primarily affect the nerves.
  2. Arterial TOS: Involves compression of the arteries.
  3. Venous TOS: Involves compression of the veins.

The condition is more commonly observed in women and frequently affects athletes and individuals whose work involves repetitive arm movements. However, it can affect anyone.

Symptoms of Thoracic Outlet Syndrome may include:

  • Neck, shoulder, or arm pain
  • Swelling
  • Weakness
  • Tingling and numbness
  • Cold hands
  • Discoloration (red, blue, or pale colors)
  • Atrophy (wasting away) of muscle or tissue in the arms
  • Painful lump near the collarbone
  • Weak pulse in the affected arm
  • Gilliatt-Sumner hand, which refers to the shrinking of the muscle in the fleshy base of the thumb

Risk factors and causes of Thoracic Outlet Syndrome include:

  • Injuries such as whiplash, broken collarbone, or injuries resulting in scar tissue and inflammation
  • Repetitive stress from specific arm movements
  • Poor posture, which can cause the collarbone to shift and press on the nerves, and weak shoulder muscles contributing to bad posture
  • Sleep disorders
  • Obesity, which can exert additional pressure on the muscles
  • Depression or stress

When diagnosing Thoracic Outlet Syndrome, the doctor may inquire about the symptoms’ history and perform a physical examination. Imaging tests like X-rays, CT scans, MRIs, or ultrasounds can help identify abnormal physical features or detect blockages or narrowing of blood vessels. Treatment options vary depending on the type of Thoracic Outlet Syndrome and may include medications such as ibuprofen or naproxen, Botox injections, and occasionally surgery.

It is crucial to seek timely treatment for Thoracic Outlet Syndrome to prevent potential complications such as nerve damage, blood clots, and circulatory problems.