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UR Medicine / Neurosurgery / Services / Peripheral Nerve Surgery Program / Conditions / Thoracic Outlet Syndrome

 

Thoracic Outlet Syndrome

What is thoracic outlet syndrome?

Thoracic outlet syndrome occurs when the blood vessels and/or nerves between your collar bone and first rib are pinched.

Thoracic

What causes thoracic outlet syndrome​?

There are various causes of thoracic outlet syndrome including trauma to this area of your shoulder/chest, repetitive movements or injuries (often sports-related), tumors within the chest, poor posture, and congenital structural defects such as having an extra rib.

Who is at risk for thoracic outlet syndrome​?

Thoracic outlet syndrome is most common in females between the ages of 20-40. Athletes are also at a higher risk.

What are the symptoms of thoracic outlet syndrome?

  • Pain that begins along the top of the shoulder near the clavicle and radiates into the pectoral muscle below the clavicle, behind the shoulder into the scapular region, and down the inward portion of the arm into the thumb and index finger
  • Muscle atrophy near the base of the thumb
  • Weak hand grip

How is thoracic outlet syndrome​ diagnosed?

  • Patient history
  • Physical exam
  • Provocation tests, which are tests designed to reproduce your symptoms
  • Imaging: X-ray, VT, MRI, venography
  • Electromyography (EMG)

How is thoracic outlet syndrome​ treated?

Nonsurgical

Physical therapy, NSAIDs

Surgical

A thoracic outlet decompression can vary depending on the cause of compression. It may involve removal of the first rib or removal of an extra rib, removal of a certain muscle in the chest, a tumor, or scar tissue from an injury.