Thoracic Outlet Syndrome (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
In this Article
- Thoracic outlet syndrome facts
- What is thoracic outlet syndrome?
- What causes thoracic outlet syndrome?
- What are risk factors for thoracic outlet syndrome?
- What are symptoms of thoracic outlet syndrome?
- How do physicians diagnose thoracic outlet syndrome?
- What is the treatment for thoracic outlet syndrome?
- What is the prognosis for thoracic outlet syndrome?
- Is it possible to prevent thoracic outlet syndrome?
What causes thoracic outlet syndrome?
An inadequate passageway for these nerves and blood vessels as they pass through an area (thoracic outlet) between the base of the neck and the armpit causes thoracic outlet syndrome. Thoracic outlet syndrome can be caused by weight-lifting, obesity, tumors in the chest, and extra ribs extending from the seventh cervical vertebra at the base of the neck.
What are risk factors for thoracic outlet syndrome?
Risk factors include occupations that involve heavy usage of the upper extremities against resistance, including jack-hammer operators and dental hygienists, weight lifters, pregnant women, and obese individuals.
What are symptoms of thoracic outlet syndrome?
Symptoms include neck, shoulder, and arm pain, numbness, or impaired circulation and flushed sensations to the extremities (causing discoloration). Often symptoms are reproduced when the arm is positioned above the shoulder or extended. Patients can have a wide spectrum of symptoms from mild and intermittent to severe and constant. Pains can extend to the fingers and hands, causing weakness.
How do physicians diagnose thoracic outlet syndrome?
The diagnosis of thoracic outlet syndrome is suggested by the symptoms and supported by findings of the doctor during the examination. Certain maneuvers of the arm and neck can produce symptoms and blood vessel "pinching," causing a loss of pulse. Further supportive testing can include electrical tests, such as electromyogram (EMG) and somatosensory evoked responses (although these may not be positive in all patients). Some patients can have angiogram X-ray tests that demonstrate the pinched area of the blood vessel involved.
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