What is Thoracic Outlet Syndrome?

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

TOS is most common in people between the ages of 20 and 50, and it is more common in women than in men. The exact cause of TOS is unknown, but it is thought to be caused by a combination of factors, including:

Anatomical abnormalities, such as a cervical rib (an extra rib that extends from the neck) or a narrowing of the thoracic outlet
Trauma, such as a sports injury or a car accident
Repeated use of the arms, such as in certain occupations or sports
Symptoms of Thoracic Outlet Syndrome
The symptoms of TOS can vary from person to person, but they often include:

Pain in the shoulder, neck, or arm
Numbness or tingling in the fingers
Weakness in the arm
Swelling in the hand or arm
Coldness in the hand or arm
Raynaud's phenomenon (a condition that causes the fingers to turn white, blue, or red in response to cold or stress)
Diagnosis of Thoracic Outlet Syndrome
There is no single test that can diagnose TOS. Your doctor will likely perform a physical examination and ask you about your symptoms. They may also order imaging tests, such as an MRI or ultrasound, to look for any anatomical abnormalities that may be causing the compression.

Treatment for Thoracic Outlet Syndrome
The treatment for TOS will vary depending on the severity of your symptoms. In some cases, non-surgical treatments, such as physical therapy, pain medication, or injections, may be enough to relieve your symptoms. In other thoracic outlet syndrome symptoms cases, surgery may be necessary to relieve the compression of the nerves or blood vessels.

Physical Therapy
Physical therapy can help to improve your range of motion, strength, and flexibility in your neck, shoulder, and arm. It can also help to reduce pain and inflammation.

Pain Medication
Pain medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or prescription pain relievers, can help to relieve pain and inflammation.

Injections of corticosteroids or numbing medications can help to relieve pain and inflammation.

Surgery may be necessary to relieve the compression of the nerves or blood vessels in the thoracic outlet. There are a variety of surgical procedures that can be used to treat TOS, and the best procedure for you will depend on your specific situation.

Recovery from Thoracic Outlet Syndrome
The recovery time from TOS treatment will vary depending on the type of treatment you receive. If you have non-surgical treatment, you may be able to return to your normal activities within a few weeks. If you have surgery, you may need to stay in the hospital for a few days and may have to wear a sling or brace for several weeks.

Prognosis for Thoracic Outlet Syndrome
The prognosis for TOS is generally good. With treatment, most people are able to get relief from their symptoms and return to their normal activities.

If you are experiencing pain, numbness, or weakness in your shoulder, neck, or arm, it is important to see a doctor to get a diagnosis. TOS is a treatable condition, and early diagnosis and treatment can help to improve your chances of a full recovery.

If you have been diagnosed with TOS, there are a number of resources available to help you. The Thoracic Outlet Syndrome Association (TOSA) is a nonprofit organization that provides information and support to people with TOS. You can find more information on their website at www.tosa.org.

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