Orthopaedic Conditons & Treatments

Thoracic Outlet Syndrome Symptoms and Causes

Thoracic Outlet Syndrome is a relatively rare condition that occurs when the shoulder muscles in your chest are not strong enough to hold the collarbone (clavicle) in place. As a result, your collarbone slips down and forward, putting pressure on the nerves and blood vessels below it. Symptoms of thoracic outlet syndrome range from pains in your neck to discoloration (bluish hue) of your hands to a throbbing sensation near your collarbone.

Thoracic Outlet Syndrome Types

There are three types of Thoracic Outlet Syndrome:

  • Neurological (Neurogenic) Thoracic Outlet Syndrome – The network of nerves coming from your spinal cord that control movements in your shoulder, arms and hands are compressed.
  • Vascular Thoracic Outlet Syndrome – One or more of the arteries under the collarbone (clavicle) are compressed.
  • Non-specific Thoracic Outlet Syndrome – Patients have chronic pain of the thoracic outlet that worsens with activity. The specific cause of the pain is still under investigation.

Thoracic Outlet Syndrome Symptoms

You may experience one or more of the following common symptoms of Thoracic Outlet Syndrome:

  • Discoloration of your hand – it turns a bluish color
  • Arm pain
  • Swelling – possibly because of a blood clot
  • Numbness and tingling – in your pinky and ring fingers and the inner forearm
  • Pain and tingling – in your neck and shoulders
  • Throbbing near your collarbone
  • Blood clot under your collarbone
  • Pallor (lack of color) in one or more fingers
  • Weak pulse in your affected arm
  • Tiny black spots (infarcts) on your fingers
  • Weakness of the muscles in your hand

Thoracic Outlet Syndrome Causes

  • Anatomical Defects – Some people are born with an extra rib or an abnormally tight fibrous band connecting the spine to the rib.
  • Trauma – Car accidents can compress the nerves in the thoracic outlet. Other traumatic accidents are often involved.
  • Poor Posture – Drooping shoulders or holding your head forward can cause compression in the thoracic outlet.
  • Pregnancy – Due to the fact that joints loosen during pregnancy, the first symptoms of thoracic outlet syndrome might show up during this time.
  • Repetitive Motion – Typing on a computer for extended periods is one possible cause. Working on an assembly line and doing the same motion over and over can also contribute to the development of thoracic outlet syndrome.
  • Obesity – Extra weight puts pressure on your joints.

Treatments for thoracic outlet syndrome range from medications and strengthening exercises to surgery.

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Shoulder and Elbow Services in New York treat thoracic outlet syndrome as well as a broad range of shoulder and elbow conditions that can occur at any stage of life.

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