Thoracic Outlet Syndrome

Thoracic outlet syndrome occurs when the blood vessels or nerves in the thoracic outlet - the space between your collarbone and your firs rib - become compressed. This can cause pain in your shoulders and neck and numbness in your fingers. Common causes include physicial trauma, certain anatomical defects, such as having an extra rib and pregnancy.

Symptoms

People with long necks and droopy shoulders are more likely to develop this condition because of extra pressure on the nerves and blood vessels.

 Symptoms include:

  • Pain, numbness and tingling in the pinky and ring fingers, and the inner forearm

  • Pain and tingling in the neck and shoulders (carrying something heavy may make the pain worse)

  • Signs of poor circulation in the hand or forearm (a bluish color, cold hands or a swollen arm)

  • Weakness of the muscles in the hand 

Diagnosis

Diagnosing thoracic outlet syndrome can be difficult because symptoms vary greatly. To diagnose thoracic outlet syndrome, your doctor may perform a physical exam and ask about your medical history. Your doctor may also opt to do provocation tests, which are designed to reproduce your symptoms and help determine the cause of your condition. To confirm the diagnosis of thoracic outlet syndrome, your doctor may also order the following tests to determine the area and cause of compression:

  • X-Ray

  • MRI

  • Electromyography (EMG)

  • Nerve conduction study

  • CT Angiogram 

Treatment

In most cases, conservative treatment such as physical therapy and medication is effective, especially when the condition is diagnosed early.However, if symptoms still continue to worsen and you experience incapacitating pain or signs of significant nerve damage, surgery is recommended. Surgery is the only option if you have been diagnosed with neurogenic thoracic outlet syndrome. The most common surgical procedure for thoracic outlet syndrome treatment is the anterior supraclavicular approach, in which your doctor makes an incision in your neck and repairs compressed blood vessels.

Dr. Joseph Ricotta
Northside Vascular Surgery
(770) 292-3490
Atlanta & Forsyth
www.nvs-ga.com



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