Thoracic Outlet Syndrome
The thoracic outlet is a triangular shaped opening to the chest
located at the base of the neck. Through this outlet, exit the main
vein, artery, and nerves that supply the arm. In some individuals
the outlet, becomes narrowed because of muscle spasm due to fibrous
bands, scar tissue, or bony abnormalities. Compression of the vein,
artery or nerves can occur when this happens.
Symptoms and Diagnosis
Symptoms of this syndrome is complex because symptoms may vary.
Problems with the nerves can include numbness and/or pain in the
hand, arm, or shoulder. Additionally, when nerves are compressed, it
is not uncommon to feel neck and facial pain as well. If the vein is
compressed, it causes swelling and color changes in the arm. If the
artery is involved, an aneusym may form and small clots may be
passed into the arm.
Treatment
Once the diagnosis of thoracic outlet syndrome is made, two
courses are available for treatment: physical therapy and/or
surgery. In some cases an gentle stretching program can relieve
nerve compression symptoms. This is done by giving patients a regime
to follow using alternative therapies easing the neurologic symptoms
above. Specialized therapists in the feild of TOS will work with our
patients prior to surgery and follow their progress postoperatively.
All of these treatments will be arranged prior to your visit.
If this therapy is not successful and pain or disability is
interfering with daily tasks, surgery may be considered. If
circulation to the arm is compromised or major nerve damage is
found, surgery may be recommended without physical therapy. Prior to
surgery, your doctor will have a thorough discussion of your
symptoms, expected benefits and potential complications of TOS
surgery. You will have all the information available to make an
informed decision.
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