Thoracic Outlet Syndrome - Everything You should Know

Cardiology | by Dr. Rakesh Sarkar | Published on 15/02/2023

Overview- Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a group of conditions that grow when there is compression, injury or irritation in the blood vessels or nerves. It causes pain and swelling including other symptoms in your thoracic outlet, the opening between the lower neck and upper chest. The causes of TOS aren’t known, however, it is believed that it can be triggered by some structural anomalies, car incidents, and repetitive actions. The treatment for this condition comprises physical therapy and medication.

If you have recently experienced compression or injury in the blood vessels, then you should know about thoracic outlet syndrome. In this blog, we are going to discuss this comprehensively, so read it till the end. However, this write-up doesn’t construe the consultation of a doctor, so make sure to visit a cardiologist specialist in Kolkata for a check-up.

What are the types of thoracic outlet syndrome?

The types of thoracic outlet syndrome are:

• Neurogenic- This type affects the nerves leading from the spinal cord to the arm to the neck.
• Venous- It affects veins in the body
• Arterial- Arteries are affected by this type

What are the symptoms of thoracic outlet syndrome?

If you are diagnosed with thoracic outlet syndrome, you are most likely to experience the symptoms in your hands and arms. Other thoracic outlet syndrome symptoms:

• The feeling of numbness and tingling
• Weakness
• Pain and swelling in the neck, arm, and back
• Weak pulse in the affected arm
• Cold hands
• Atrophy
• Muscle shrinking in the fleshy thumb base
• Painful lump near collarbone

What are the causes of thoracic outlet syndrome?

There are numerous causes of thoracic outlet syndrome which include:

• Poor posture- It occurs due to weak shoulder muscles
• Injuries- A broken collarbone, whiplash, or other injury leads to leaving scar tissue and inflammation causing TOC
• Physical defects- There are people born with an additional or a thoracic outlet that is smaller
• Pregnancy- TOS can occur as it causes joints to become loose
• Sleep disorders
• Tumour- If a tumor is there in the upper chest or under the arm, it causes TOS
• Stress or depression

It is revealed in studies that thoracic outlet syndrome is more common in women than men majorly in young individuals aged around 20-40.

How is thoracic outlet syndrome diagnosed?

To diagnose thoracic outlet syndrome, the doctor begins by performing a physical evaluation and reviewing the symptoms including clinical history. The doctor might also include provocation tests for assessing the condition comprehensively. These tests are useful in reproducing the symptoms so that doctors can make a proper diagnosis of the condition. The doctor will ask the patient to move the neck, arms, and shoulders in varied positions.

Here are other tests for confirming the diagnosis, the doctor might order the following tests:

• A thoracic outlet X-ray is ordered for revealing whether the patient has an additional rib. It will also help in ruling out other conditions causing symptoms
• Magnetic resource imaging is recommended as it assists in creating detailed and clear thoracic outlet images using powerful magnets and radio waves. It will also benefit in determining the compression location and cause
• Electromyography tests allow the doctor for identifying whether the muscles and nerves in the thoracic outlet are functioning well or not. The test also assists in evaluating the electrical activity of the muscles
• A nerve conduction study is also ordered for measuring how well the nerves can send impulses to several muscles throughout the body. The doctor can also identify if there is any nerve damage

How is thoracic outlet syndrome treated?

The early diagnosis of thoracic outlet syndrome helps in improving the treatment's success. The treatment for TOS differs depending on its type and symptoms. This treatment aims to reduce symptoms and pain. The doctor recommends a treatment that is right for the patient.

It is essential to consult the doctor before choosing any treatment about the probable benefits, side effects, and risks of the treatment options. Here are some of the recommended treatment options:

• Physical therapy- It is one of the most common treatments for thoracic outlet syndrome. Usually, it is used for neurogenic types and helps in enhancing the motion range of the shoulders and neck. This treatment also benefits in strengthening muscles and promoting the better posture
• Medications are given for pain relief which include over-the-counter medications like ibuprofen, acetaminophen, and aspirin.
• Surgery is recommended mainly to treat the neurogenic type if other treatment options aren’t helping with reducing the symptoms
• Thrombolytic medications are given so that blood clots are dissolved. This type is primarily used for venous thoracic outlet syndrome This treatment is given in the hospital so that the patient is monitored closely.
• Anticoagulant medications are also recommended for decreasing the blood’s efficiency to form clots and preventing more clots from forming. The medications are warfarin, low-molecular-weight heparin, heparin, and fondaparinux

How to prevent thoracic outlet syndrome?

It is not possible to avert thoracic outlet syndrome, but if you experience this condition, you can include some steps that will help in reducing the symptoms. Here are the steps:

• Practice the right posture when standing or sitting
• Take breaks in between work or school for stretching and moving around
• Maintain a healthy weight
• Avoid actions making symptoms worse
• Don’t make repetitive movements
• Don’t carry heavy bags on the shoulders
• Make sure to perform strengthening exercises daily
• Don’t lift heavy objects

Conclusion

It is vital to consult the cardiologist as soon as you observe the symptoms of thoracic outlet syndrome. Getting immediate treatment is crucial as it helps in averting complications. If the condition is left untreated, it can eventually cause permanent neurological damage.

FAQs

Is thoracic outlet syndrome serious?

Yes, thoracic outlet syndrome can be life-threatening if not treated on time and can cause serious problems like pulmonary embolism and blood clots. It can also lead to permanent nerve damage.

What is the right sleep position for thoracic outlet syndrome?

The best position to sleep with thoracic outlet syndrome is laying on the back. You can also sleep on the non-affected side.