What is Thoracic Outlet Syndrome?

The thoracic outlet is the area between the top rib and the collarbone. Thoracic outlet syndrome occurs when nerves or blood vessels near the thoracic outlet are somehow squeezed or constricted. The syndrome has three main types: neurological, vascular, or nonspecific.

The most common form of thoracic outlet syndrome is neurological, which is a result of the brachial plexus, a group of spinal cord nerves, becoming pinched or constricted. These nerves are responsible for moving the arms, shoulders, and hands, and its main symptom may be a tingling sensation in the fingers or hands. It can also cause pain or stiffness in the shoulders, arms, neck, or hands, which can lead to difficulty moving the hand or grasping items.

Vascular thoracic outlet syndrome occurs when the blood vessels directly under the collar bone become narrowed. A person with this type of the syndrome will often experience soreness of the arm, which may become swollen if a blood clot occurs within the constricted blood vessel. He or she may also feel an intense pain near the collarbone. The syndrome can cause the hand to look extremely pale or else be discolored with a blue tint or small black spots covering the hand or fingers.

If a person experiences pain near the collarbone that does not appear to be caused by brachial plexus or blood vessels, it is often known as nonspecific or common thoracic outlet syndrome. This syndrome is a broad term assigned to any pain around the thoracic outlet that is of an undetermined cause. It is not as common of a diagnosis as neurological or vascular and some doctors don’t believe it is a different variety of the syndrome.

The nerve or blood vessel constriction that causes thoracic outlet syndrome can occur due to injury to the spine or collarbone, repeated movement of the areas, or even slouching, which puts strain on the spine and shoulders. The syndrome can also occur if heavy weight is carried and putting extra pressure on the nerves and blood vessels. This can be caused by being overweight, pregnant, or even wearing a heavy backpack. Genetic abnormalities of the ribs or collarbone can also contribute to the syndrome.

Mild cases of the syndrome can be treated with physical therapy that can help loosen the constricted areas. Anti-inflammatory medications can help reduce swelling of the areas and lessen the pain. If the condition worsens, a doctor may perform surgery and cut into the constricted area to loosen any squeezed nerves or blood vessels.