Thoracic outlet syndrome

Definition of Thoracic outlet syndrome

Thoracic outlet syndrome is a rare condition that involves pain in the neck and shoulder, and of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collar bone.

Causes, incidence, and risk factors

Blood vessels and nerves coming from the spine or major blood vessels of the body pass through a narrow space near the shoulder and collarbone on their way to the arms. As they pass by or through the collarbone (clavicle) and upper ribs, they may not have enough space.

Symptoms

Symptoms of thoracic outlet syndrome may include:

Signs and tests

When you lift something, the arm may look pale due to pressure on the blood vessels.

Treatment

When thoracic outlet syndrome affects the nerves, the first treatment is always physical therapy. Physical therapy helps strengthen the shoulder muscles, improve range of motion, and promote better posture. Treatment may also include pain medication.

Expectations (prognosis)

Having the first rib removed and the fibrous bands broken may relieve symptoms in certain patients. Surgery can be successful in 50% to 80% of patients. Conservative approaches using physical therapy are helpful for many patients.

Review

Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. – 11/1/2010

Thoracic outlet anatomy

ADAM Medical Encyclopedia

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