Thoracic Outlet Syndrome (TOS)

Thoracic outlet syndrome (TOS) is a time period used to explain a gaggle of problems that occur when there may be compression, injury, or irritation of the nerves and/or blood vessels (arteries and veins) in the lower neck and upper chest area. Thoracic outlet syndrome is named for the house (the thoracic outlet) between your lower neck and higher chest the place this grouping of nerves and blood vessels is found.

Who’s affected by thoracic outlet syndrome?

Thoracic outlet syndrome impacts people of all ages and gender. The condition is common among athletes who participate in sports that require repetitive motions of the arm and shoulder, resembling baseball, swimming, volleyball, and different sports.

Neurogenic TOS is the commonest form of the dysfunction (95 % of individuals with TOS have this form of the dysfunction) and generally affects middle-aged women.

Recent research have shown that, basically, TOS is more common in women than men, particularly amongst those with poor muscular development, poor posture or both.

The signs and symptoms of TOS embody neck, shoulder, and arm pain, numbness or impaired circulation to the affected areas.

The pain of TOS is usually confused with the pain of angina (chest pain as a consequence of an inadequate provide of oxygen to the center muscle), however the conditions will be distinguished because the pain of thoracic outlet syndrome does not happen or increase when walking, while the pain of angina often does. Additionally, the pain of TOS typically increases when elevating the affected arm, which doesn’t occur with angina.

Signs and signs of TOS assist determine the type of disorder a patient has. Thoracic outlet syndrome issues differ, depending on the part(s) of the body they affect. Thoracic outlet syndrome most commonly affects the nerves, however the condition may also affect the veins and arteries (least widespread type). In all types of TOS, the thoracic outlet area is narrowed, and there may be scar formation around the structures.

Types of thoracic outlet syndrome problems and related signs

Neurogenic thoracic outlet syndrome: This condition is said to abnormalities of bony and soft tissue within the lower neck region (which may include the cervical rib area) that compress and irritate the nerves of the brachial plexus, the advanced of nerves that provide motor (movement) and sensory (feeling) function to the arm and hand. Signs embody weakness or numbness of the hand; decreased size of hand muscle tissue, which often occurs on one side of the body; and/or pain, tingling, prickling, numbness and weakness of the neck, chest, and arms.

Venous thoracic outlet syndrome: This condition is caused by damage to the major veins in the lower neck and upper chest. The condition develops all of the sudden, often after unusual and tiring exercise of the arms. Signs include swelling of the hands, fingers and arms, as well as heaviness and weakness of the neck and arms. The veins in the anterior (front) chest wall veins also could appear dilated (swollen).

Arterial thoracic outlet syndrome: The least common, but most severe, type of TOS is caused by congenital (present at birth) bony irregularities within the lower neck and upper chest. Signs embody cold sensitivity within the palms and fingers; numbness, pain or sores of the fingers; and poor blood circulation to the arms, fingers and fingers.

What causes thoracic outlet syndrome?

The disorders caused by TOS will not be well understood. Yet, it is known that when the blood vessels and/or nerves in the tight passageway of the thoracic outlet are abnormally compressed, they grow to be irritated and may cause TOS. Thoracic outlet syndrome generally is a results of an additional first rib (cervical rib) or an old fracture of the clavicle (collarbone) that reduces the house for the vessels and nerves. Bony and soft tissue abnormalities are among the many other causes of TOS. The next might improve the risk of developing thoracic outlet syndrome:

Sleep disorders

Tumors or giant lymph nodes in the upper chest or underarm space

Stress or depression

Participating in sports that involve repetitive arm or shoulder movement, similar to baseball, swimming, golfing, volleyball and others

Repetitive injuries from carrying heavy shoulder loads

Injury to the neck or back (whiplash injury)

Poor posture

Weightlifting

How is thoracic outlet syndrome treated?

Early identification of TOS will help improve the success of treatment. Thoracic outlet syndrome deal withments vary, relying on the type of TOS you’ve and your symptoms. The goals of treatment are to reduce symptoms and pain. Your health care provider will recommend the deal withment option that’s right for you.

Before choosing any deal withment, it is important to talk to your health care provider about the potential benefits, risks and side effects of your deal withment options.

Deal withment of neurogenic thoracic outlet syndrome

Physical therapy: The commonest initial treatment for neurogenic thoracic outlet syndrome is physical therapy. Physical therapy increases the range of motion of the neck and shoulders, strengthens muscular tissues and promotes higher posture. Most patients experience an improvement in symptoms after undergoing physical therapy.

Medications: For pain aid, over-the-counter pain drugs, similar to aspirin, acetaminophen (Tylenol), or ibuprofen (Motrin), may be recommended. Your physician might prescribe a muscle relaxant for additional pain relief.

Surgery: In some cases, surgical procedure may be wanted to treat neurogenic thoracic outlet syndrome if signs continue, despite an optimum course of physical therapy.

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