Thoracic Outlet Syndrome

Thoracic outlet syndrome is characterized by the compression of nerves or blood vessels in the space between the first rib and the collarbone. The patients experience numbness and neck pain. The other symptoms depend upon the types of nerves or blood vessels that are compressed.

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  • Cervical Rib: In some people, an extra rib is present above the first rib. It grows from the neck base, just above the collarbone. The patients may have the cervical rib on the right, left, or on both sides. The cervical rib may be present as a fully developed rib or just a stand of tissues. The condition is present from birth and does not usually cause any problems. However, if the rib compresses the nearby nerves and vessels, the patients experience numbness and neck pain. It is one of the causes of thoracic outlet syndrome.
  • Arterial TOS: This condition affects the artery between the collarbone and the ribs. The space between the collarbone and ribs is known as the thoracic outlet. The compression of the arteries in this region is known as the thoracic arterial outlet. Patients with this condition may develop a blood clot in the artery. These blood clots can break from the arteries and travel to the lungs, leading to pulmonary embolism. In most cases, the compression of the artery may be due to the cervical rib.
  • Venous TOS: The subclavian vein carries the blood from the arm to the heart. Compression of this vein is known as venous thoracic outlet syndrome. Patients with this condition experience arm pain, discoloration, and swelling of the arms. The condition is also known as Paget-Schroetter syndrome. Overusing the arm and shoulder, especially by people with a narrow passage to the subclavian vein, causes venous TOS. The other causes are physical trauma, carrying heavy weight, and pregnancy.
  • Neurogenic TOS: The Brachial plexus is the nerve network that originates from the spinal cord and controls the arm, shoulder, and hand movements. Compression of the brachial plexus is termed neurogenic TOS.