Thoracic Outlet Syndrome- Everything You Need to Know

Orthopedics & Joint Replacement | by Dr. Ayan Roy | Published on 28/07/2023

Overview- Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is an amalgamation of conditions that happens when there is irritation in the blood vessels, due to compression or injury. The condition leads to pain and swelling which also involve other symptoms in the thoracic outlet. A thoracic outlet is an opening between the upper chest and the lower neck. According to studies, the causes of thoracic outlet syndrome haven’t been known yet. However, it is believed that it can cause structural anomalies triggers, and other occurrences like car accidents or repeated actions. Usually, the treatment options involved for this condition are medication and physical therapy.

In this blog, we will cover the information related to thoracic outlet syndrome including its causes, symptoms, diagnosis, and treatment. But before we move forward with the discussion, remember that this write-up in any condition doesn’t interfere with the consultation of a doctor. If you suspect thoracic outlet syndrome symptoms, then make sure to book your appointment with the healthcare professionals at The Calcutta Medical Research Institute in Kolkata, one of the best multispecialty hospitals. You will find the most experienced and highly-skilled doctors in their respective fields.

What are the types of thoracic outlet syndrome?

There are three main types of thoracic outlet syndrome which include:

• Neurogenic- This thoracic outlet syndrome type affects different parts of the body such as nerves, spinal cord, arm, and neck
• Venous- This type is known for affecting veins in the body
• Arterial- This type leads to affecting arteries in the body

What are thoracic outlet syndrome symptoms?

People who are diagnosed with TOS condition; often experience symptoms in their hands and arms. However, there are other thoracic outlet syndrome symptoms which include: 

• Swelling and pain in the back, arm, and neck
• Cold hands
• Tingling and numbness feeling
• Atrophy
• Experiencing pain near the collarbone
• Shrinking of muscle in the fleshy thumb base
• Weakness
• Weak pulse in the arm

What are thoracic outlet syndrome causes?

There are various thoracic outlet syndrome causes such as:

• Poor posture happens because of the weak shoulder muscles
• Physical defects as there are individuals who are born with extra or smaller thoracic outlet
• Sleeping disorders
• In pregnancy, TOS occurs as it causes muscle and joints looseness leading to pain in the arm, hands, or neck
• Tumour is another primary cause of TOS, primarily when it exists in the upper chest or under the arm
• Injuries like whiplash, broken collarbone, or other injuries can cause scar tissue and inflammation leading to thoracic outlet syndrome
• Stress and depression

According to studies, it is found that thoracic outlet syndrome is more common in females than males, especially in younger women aged around 20-40.

How is thoracic outlet syndrome diagnosed?

The doctor initiates the thoracic outlet syndrome diagnosis by performing a physical assessment and evaluating the symptoms of an individual depending on their clinical and family history. To confirm the diagnosis, the doctor might also involve provocation tests as they assist in assessing the condition widely. These tests also assist in reproducing the symptoms allowing the doctors to be certain about the diagnosis. The patient might be asked to move their shoulders, neck, and arms in different positions.

Here are some of the usual tests recommended by the doctor for thoracic outlet syndrome diagnosis:

• A thoracic outlet X-ray- It helps in detecting if the patient has an extra rib or not. With this test, any other underlying condition also can be ruled out.

• MRI or magnetic resonance imaging test- It is ordered to create comprehensive and clear pictures of the thoracic outlet syndrome with the use of powerful magnets and radio waves. The location and cause of the condition can also be determined with this test.

• Electromyography tests: It permits the doctor to identify whether the nerves and muscles in the thoracic outlet are working well or not. It helps in assessing the muscle's electrical activity.

• A nerve conduction study- It is recommended to measure the nerves functioning and how well they can send the impulses to various muscles all over the body. It also benefits in identifying nerve damage.

How is thoracic outlet syndrome treated?

It is essential to understand that the thoracic outlet syndrome early diagnosis benefits in enhancing the success of treatment. A thoracic outlet syndrome treatment options vary depending on the patient’s symptoms and type. The main aim of the treatment is to reduce the pain and symptoms of the patient.

It is recommended to get in touch with the doctor before picking any treatment to understand the possible benefits, risks, and side effects of the options. Some of the usually recommended treatment options are:

• Physical therapy is the most prescribed treatment option for thoracic outlet syndrome. It is often recommended for neurogenic type as it benefits in increasing the shoulders and neck motion range. It strengthens the muscles and promotes better posture for the patient.

• Certain medications are prescribed for pain relief like OTC drugs such as aspirin, ibuprofen, and acetaminophen.

• Surgery is the last resort if other treatment options are not working well. It treats the neurogenic type and reduces the symptoms.

• Thrombolytic medications are ordered for dissolving the blood clots and are usually recommended for venous thoracic outlet syndrome type.

• Anticoagulant medications are ordered to reduce the blood’s efficiency for clot formation and avert more clot formation. These medications involve warfarin, heparin, fondaparinux, heparin, and low-molecular-weight heparin.

How to prevent thoracic outlet syndrome?

It is important to note that thoracic outlet syndrome prevention is not possible but certain steps can be included to reduce the symptoms. Here are these steps:

• Make sure to practice the right posture while you are standing or sitting
• Ensure healthy weight
• Avoid repetitive movements
• Avoid lifting heavy objects
• Carrying heavy bags on the shoulders should be avoided
• Make sure to take breaks in between work or school
• Keep stretching during the day
• Involve strengthening exercises in your daily routine

Conclusion

A thoracic outlet syndrome is a condition that might construe with the regular schedules of an individual. It sometimes feels irrational to take time away from work or slow down the pace. In this condition, patience is key. If you are diagnosed with TOS, make sure to take care of yourself with treatment options like physical therapy or other options to regain strength and feel better. If you don’t find a way out, then book your appointment with the experienced and skilled doctors at The Calcutta Medical Research Institute in Kolkata.

FAQs

Which fingers are affected by thoracic outlet syndrome?

In thoracic outlet syndrome, one can experience pain and numbness in the pinky and ring fingers. 

Can thoracic outlet syndrome be cured?

Yes, thoracic outlet syndrome can be cured with physical therapy and medications.