Thoracic Outlet Syndrome Specialist

What is thoracic outlet syndrome?

Thoracic outlet syndrome (TOS) occurs when the nerves or blood vessels in the area between your collarbone and ribcage (the thoracic outlet) become compressed. The syndrome occurs most frequently in people whose occupations or hobbies require use of the upper extremities against force, such as construction workers who use jackhammers or weightlifters, but it can develop from other causes as well.

What causes thoracic outlet syndrome to occur?

Thoracic outlet causes can vary, and may include:

• anatomical abnormalities, including being born with an extra rib or having very tight ligaments

• traumatic injury, such as a car accident or serious fall

• poor posture that causes the shoulders to “droop” forward

• repetitive motion, such as typing for long hours, competitive swimming or working on an assembly line

• obesity, which causes chronic increased stress on joints and other tissues

• pregnancy, which can cause joints to become loose and also increase pressure on joints

• prolonged periods of pressure on the joints, such as carrying a backpack or heavy messenger bag day after day

What symptoms does TOS cause?

Thoracic outlet syndrome may cause different symptoms depending on whether nerves or blood vessels – or both – are involved. The most common symptoms include:

• pain and numbness in the neck, shoulder, arm or hand

• discoloration in the arm and hand

• cool temperature in the arm and hand

• weakness in the arm or neck

• tingling sensations in the hands and fingers

• arm fatigue

• weakened pulse in the arm

How is thoracic outlet syndrome treated?

Treatment of TOS begins conservatively with medications to reduce inflammation, relax muscles or dissolve clots, physical therapy and exercises to improve posture. When these approaches fail to provide relief, a type of surgery called thoracic outlet decompression may be needed.