Thoracic outlet syndrome
About Thoracic outlet syndrome
The thoracic outlet is the region where neurovascular structures exit the chest. It is composed of the first rib, the subclavian artery and vein, the brachial plexus and the upper part of the lung. Any enlargement or movement in these structures can cause compression of the nerve or blood vessels. Occasionally patients will have an extra rib that causes the syndrome. This compression causes the symptoms experienced in the neck and arm. It occurs more often in women between ages 35 and 55.Symptoms
Pain, numbness, and tingling in the last three fingers and inner forearm. Pain and tingling in the neck and shoulders. Bluish discoloration of the hand, weakness of the muscles in the hand. Symptoms can become worse with lifting the arm above the head.Tests & Diagnostics
A history and physical exam will be performed. Tests to establish the diagnosis may include: X-ray (to reveal an extra rib), MRI, nerve conduction velocity study, and electromyography (EMG).Common tests: MRI, X-ray.
OTC sleep aids and supportive treatments
Prescription medications
Conventional treatment summary
Therapy depends on the severity of the illness, and the specific cause of the disorder. Treatment may include: physical therapy, behavioral modifications, losing weight, nonsteroidal anti-inflammatory medications/NSAIDs (ibuprofen/Motrin or Advil, naproxen/Naprosyn or Aleve), and/or pain medications such as acetaminophen (Tylenol). Surgery may be necessary for persistent or severe symptoms.Medical specialties
Cardiothoracic Surgery
This page is educational content, not medical advice. Always consult a qualified clinician for diagnosis and treatment of Thoracic outlet syndrome.