2
4
5
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Thoracic outlet anatomy
Thoracic outlet anatomy

Thoracic outlet syndrome
Definition:
Thoracic outlet syndrome is a condition characterized by pain in the neck and shoulder, numbness/tingling of the fingers, and weakening of the grip.

Causes, incidence, and risk factors:

Thoracic outlet syndrome is a rare condition caused by compression of blood vessels and nerves in the area of the clavicle (collar bone). This compression is caused by the presence of an extra cervical rib (above the first rib) or an abnormal tight fibrous band connecting the spinal vertebra to the rib.

People with long necks and droopy shoulders may be predisposed to develop this condition because of extra pressure on their nerves and blood vessels.
Symptoms:

The following symptoms may indicate thoracic outlet syndrome:

  • Discomfort in the last 3 fingers and inner forearm
    • Numbness
    • Pain
    • Tingling
  • Pain and tingling in the neck and shoulders (may be worsened by carrying something heavy, such as a suitcase)
  • Weakness and wasting of the muscles of the hand
Signs and tests:

Upon lifting, the arm may appear pale due to compression of the blood vessels. The arm may be smaller on the side of the symptoms, as this is a congenital anomaly (present since birth).

Tests to confirm the diagnosis include the following:
Treatment:

The syndrome is treated with physical therapy to strengthen the shoulder muscles.

Surgery to remove the rib or cut the band has also been tried. There is no good evidence that this is effective, and there have been reports of some patients' sympoms becoming worse after surgery. However, some carefully selected patients with demonstrated nerve conduction disorders may benefit from surgery.
Expectations (prognosis):
If selected carefully, patients undergoing removal of the fibrous band may have resolution of their symptoms. Conservative approaches using physical therapy are helpful in many patients.
Complications:
Complications can occur with any surgery and relate to the particular procedure and anesthesia used.
Calling your health care provider:
Call your health care provider if you experience any of the symptoms of thoracic outlet syndrome.
Review Date: 5/13/2002
Reviewed By: Elaine T. Kiriakopoulos, M.D., MSc, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2003 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com