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Thoracic Outlet Syndrome: Causes, Symptoms, and Treatment | JEEVISHA Pain Clinic

Thoracic Outlet Syndrome

Thoracic outlet syndrome is a group of disorders that occur when blood vessels or nerves in the space between your collar bone( Clavicle) and your first rib (thoracic outlet) are compressed. This can cause pain in your neck, shoulder and numbness in your fingers.

Types of thoracic outlet syndrome, including:


  • Neurogenic (neurological) thoracic outlet syndrome.This most common type of thoracic outlet syndrome is characterized by compression of the brachial plexus. The brachial plexus is a network of nerves that come from your spinal cord and control muscle movements and sensation in your shoulder, arm and hand.
  • Vascular thoracic outlet syndrome.This type of thoracic outlet syndrome occurs when one or more of the veins (venous thoracic outlet syndrome) or arteries (arterial thoracic outlet syndrome) under the collarbone (clavicle) are compressed.
  • Nonspecific-type thoracic outlet syndrome.This type is also called disputed thoracic outlet syndrome. Some doctors don't believe it exists, while others say it's a common disorder. People with nonspecific-type thoracic outlet syndrome have chronic pain in the area of the thoracic outlet that worsens with activity, but a specific cause of the pain can't be determined.

Signs and symptoms of neurological thoracic outlet syndrome include:


  • Muscle wasting in the fleshy base of your thumb (Gilliatt-Sumner hand)
  • Numbness or tingling in your arm or fingers
  • Pain or aches in your neck, shoulder or hand
  • Weakening grip

Signs and symptoms of vascular thoracic outlet syndrome can include:


  • Discoloration of your hand (bluish color)
  • Arm pain and swelling, possibly due to blood clots
  • Blood clot in veins or arteries in the upper area of your body
  • Lack of color (pallor) in one or more of your fingers or your entire hand
  • Weak or no pulse in the affected arm
  • Cold fingers, hands or arms
  • Arm fatigue with activity

Common causes of thoracic outlet syndrome


  • Anatomical defects. Inherited defects that are present at birth (congenital) may include an extra rib located above the first rib (cervical rib) or an abnormally tight fibrous band connecting your spine to your rib.
  • Poor posture. Drooping your shoulders or holding your head in a forward position can cause compression in the thoracic outlet area.
  • A traumatic event, such as a car accident, can cause internal changes that then compress the nerves in the thoracic outlet. The onset of symptoms related to a traumatic accident often is delayed.
  • Repetitive activity. Doing the same thing repeatedly can, over time, wear on your body's tissue. You may notice symptoms of thoracic outlet syndrome if your job requires you to repeat a movement continuously, such as typing on a computer, working on an assembly line or lifting things above your head, as you would if you were stocking shelves. Athletes, such as baseball pitchers and swimmers, also can develop thoracic outlet syndrome from years of repetitive movements.
  • Pressure on your joints. Obesity can put an undue amount of stress on your joints, as can carrying around an oversized bag or backpack.
  • Because joints loosen during pregnancy, signs of thoracic outlet syndrome may first appear while you're pregnant.

Risk factors


Thoracic outlet syndrome is a group of disorders that occur when blood vessels or nerves in the space between your collar bone( Clavicle) and your first rib (thoracic outlet) are compressed. This can cause pain in your neck, shoulder and numbness in your fingers.


  • Sex Females are far more likely to be diagnosed with thoracic outlet syndrome than are males.
  • Age Thoracic outlet syndrome is more common in young adults, between 20 and 40 years old.

Prevention


Identification of this condition is very important because if Thoracic outlet syndrome goes untreated for years can cause permanent neurological damage

If you're susceptible to thoracic outlet compression, avoid repetitive movements and lifting heavy objects. If you're overweight, you can prevent or relieve symptoms associated with thoracic outlet syndrome by losing weight.

Even if you don't have symptoms of thoracic outlet syndrome, avoid carrying heavy bags over your shoulder, because this can increase pressure on the thoracic outlet. Stretch daily, and perform exercises that keep your shoulder muscles strong.

Daily stretches focusing on the chest, neck and shoulders can help improve shoulder muscle strength and prevent thoracic outlet syndrome.

JEEVISHA protocol for management of Thoracic outlet syndrome:


  • Work ergonomics correction: Changing the Ergonomics at work place plays a very important role in management of these patients. Expert faculty at JEEVISHA analysis the problems and helps the patient bring changes in their daily life.
  • Posture correction: With facilities like Posture Analysis machine, the root cause for the development of these painful conditions is identified and patient are trained to overcome this problem in a step wise manner.
  • Physiotherapy: Physiotherapy plays a very important role in fighting these painful conditions. With a team of dedicated physiotherapist, patient is further evaluated and accordingly a plan is prepared for first reducing pain and then focusing on strengthening of the paraspinal muscles.
  • If symptoms of patients are severe then patient is adequately investigated and adviced to undergo surgery.
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