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Definition Return to top
Thoracic outlet syndrome is a condition characterized by pain in the neck and shoulder, numbness/tingling of the fingers, and weakening of the grip.Causes, incidence, and risk factors Return to top
Thoracic outlet syndrome is a rare condition caused by compression of blood vessels and nerves in the area of the clavicle (collar bone). This compression is caused by the presence of an extra cervical rib (above the first rib) or an abnormal tight fibrous band connecting the spinal vertebra to the rib.
People with long necks and droopy shoulders may be predisposed to develop this condition because of extra pressure on their nerves and blood vessels.
Symptoms Return to top
The following symptoms may indicate thoracic outlet syndrome:
Signs and tests Return to top
Upon lifting, the arm may appear pale due to compression of the blood vessels. The arm may be smaller on the side of the symptoms, as this is a congenital anomaly (present since birth).
Tests to confirm the diagnosis include the following:
Treatment Return to top
The syndrome is treated with physical therapy to strengthen the shoulder muscles.
Surgery to remove the rib or cut the band has also been tried. There is no good evidence that this is effective, and there have been reports of some patients' sympoms becoming worse after surgery. However, some carefully selected patients with demonstrated nerve conduction disorders may benefit from surgery.
Expectations (prognosis) Return to top
If selected carefully, patients undergoing removal of the fibrous band may have resolution of their symptoms. Conservative approaches using physical therapy are helpful in many patients.Complications Return to top
Complications can occur with any surgery and relate to the particular procedure and anesthesia used.Calling your health care provider Return to top
Call your health care provider if you experience any of the symptoms of thoracic outlet syndrome. Update Date: 4/19/2004 Updated by: Brian F. Burke M.D., Department of Internal Medicine, Munson Medical Center, Traverse City, MI. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |