Thoracic Outlet Syndrome

Thoracic outlet syndrome is a condition in which the nerves and blood vessels coming from the neck and shoulder are compressed. This compression causes pain and numbness.

When conservative measures do not work, surgery can be performed to decompress the nerves and blood vessels.

What is Thoracic Outlet Syndrome?

The thoracic outlet is the space between the collarbone and the first rib. This area houses blood vessels, nerves and muscles. If the shoulder muscles in the chest are not strong enough to hold the collarbone in place, it can slip down and forward compressing the nerves and blood vessels in the thoracic outlet.

“Nerve and blood vessels are being compressed as they come out of the neck and shoulder,” says Michael D. Riggenbach, M.D. “This can cause pain, numbness, discoloration in the limb and the pain can oftentimes been seen during activities such as raising your arms above your head.”

The symptoms of thoracic outlet syndrome vary depending on which nerves and blood vessels are being compressed. Symptoms can include:

  • Vague aching pain in the neck
  • Numbness
  • Tingling
  • Weakness
  • Swelling and redness of the arm
  • Difficulty performing overhead activities
  • Limited range of motion
  • A depression in the shoulder
  • Swelling or discoloration in the arm.

What Are the Treatment Options for Thoracic Outlet Syndrome?

Typically, nonsurgical treatments for thoracic outlet syndrome are recommended first. Physical therapy can strengthen the surrounding shoulder muscles. Anti-inflammatory medications can reduce the swelling and pain.

“When other conservative measures fail to try and correct posture and straighten your back, sometimes surgical procedures can be performed to help resect muscle and even bone, which can decompress the nerves and blood vessels,” explains Dr. Riggenbach. “Oftentimes blood vessel reconstruction is necessary as well.”

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