About this topic
The thoracic outlet is the area between your collarbone and first rib. Blood vessels, nerves, and muscles run through this small space. Pressure on these structures can cause signs like numbness or tingling in the fingers. You may also have a weak grip or your hand feels cold. These problems are called thoracic outlet syndrome or TOS. There are three types of TOS. ‚
Most people with TOS get good results with physical therapy and other treatments. Surgery is not often needed. ‚
What are the causes?
This illness may be caused from trauma, like a car crash. Other times, it may be caused by illness. Some people are born with an extra rib and this can make the space very small. Having poor posture and being overweight can make it worse. Doing repeated arm and shoulder movements can as well. ‚
What can make this more likely to happen?
This illness is more likely to happen if you are female, have large breasts, and are between the age of 20 to 50 years of age. It also happens more often if you have a job where you carry heavy loads on your shoulder. ‚
What are the main signs?
The signs you have will depend on what part of the thoracic outlet has pressure on it. You may have only some of these signs or you may have all of them: ‚
- Pain or achiness in the neck, shoulder, arm, armpit, or hand
- Numbness or tingling down the forearm to the 4th and 5th fingers
- Weakness in the hand, neck, or arm
- Weak or no pulse in the arm
- Arm feels heavy
- Swelling or redness in the arm or hand
- Skin turns pale or your hand changes color
- Arm or hand feels cold
- Less motion in the arm
- Problem is worse when doing overhead activities
How does the doctor diagnose this health problem?
- Your doctor will take your history. Your doctor will do an exam and feel around your collarbone, upper chest, shoulder, and arm. Your doctor will check your motion and strength. Your doctor will also check for numbness and blood flow in the arm and hand. Your doctor may have you raise your arms above your head while opening and closing your hands for a couple of minutes. If this causes your problems to get worse, you probably have thoracic outlet syndrome.
- Your doctor will do an exam and may order:
- X-ray
- CT or MRI scan
- Ultrasound
- Blood circulation tests
- Electromyelography (EMG)
- Nerve conduction velocity tests
How does the doctor treat this health problem?
- Avoid activities that make your problem worse.
- Lose weight if you are overweight
- Physical therapy (PT) for exercises and training in good posture
- Surgery in very bad cases or for those who do not get better with other care
What drugs may be needed?
The doctor may order drugs to: ‚
- Help with pain and swelling
- Prevent blood clots
What problems could happen?
- Long-term damage to nerves or blood vessels
- Weakness in the arm muscles or muscles that help with breathing
- Blood clots
What can be done to prevent this health problem?
- Do not carry heavy bags or purses on your shoulder.
- Stay active and work out to keep your muscles strong and flexible.
- Always use good posture. Do not slouch.
Where can I learn more?
American Academy of Orthopaedic Surgeons ‚
http://orthoinfo.aaos.org/topic.cfm?topic=a00336 ‚
National Institute of Neurological Disorders and Stroke ‚
http://www.ninds.nih.gov/disorders/thoracic/thoracic.htm ‚
National Organization for Rare Disorders ‚
http://www.rarediseases.org/rare-disease-information/rare-diseases/byID/1215/viewAbstract ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚