Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) involves compression of nerves, arteries, or veins in the space between the collarbone and first rib. Neurogenic TOS, the most common type, affects brachial plexus nerves, while venous and arterial forms impact blood vessels. It often stems from poor posture, repetitive overhead activities, trauma, or anatomical variations like an extra rib.

Symptoms

Patients experience neck, shoulder, or arm pain, tingling, numbness in fingers, and weakened grip. Symptoms worsen with arms elevated, causing fatigue or aching during activities. Venous TOS leads to arm swelling and bluish discoloration; arterial cases may cause cold hands or finger ulcers.

Causes and Risk Factors

Repetitive motions in athletes or workers, whiplash injuries, and congenital issues like cervical ribs contribute. Women and those aged 20-40 face higher risk, especially with poor posture or heavy backpacks.

Diagnosis and Treatment

Diagnosis uses physical exams, imaging like ultrasound or MRI, and nerve studies. First-line treatment includes physical therapy to strengthen muscles and improve posture, plus NSAIDs for pain. Severe cases may require injections, clot treatments, or surgery to release structures.