Thoracic outlet syndrome

What You Need to Know About Thoracic Outlet Syndrome (TOS)?

When the blood vessels are trampled in between the space of the first rib and collarbone, then one gets entangled into a disorder group, called Thoracic Outlet Syndrome (TOS), which can lead to the pain in neck and shoulders.

The people who face injuries, especially the athletes, are often found entangled in this issue. There can be some other reasons for having pain in the shoulders and neck muscles. Females are often found suffering from this pain, especially in pregnancy.
In this article, different causes, symptoms, and methods of diagnosis and treatments are addressed. If you are experiencing TOS or exploring it, then this article will prove very beneficial for you. So, let us get started.

What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome or TOS is a disorder that comes into view when someone gets an injury, feels irritation, and feels a burden on the blood vessels in the upper neck and shoulders. It is a name of an area that lies between the first rib and collarbone where the blood vessels of the lower chest and upper neck are found.

When the blood vessels are compressed, then this disorder happens, which can affect people of every age. But this mostly happens with the persons who are taking a part in sports where they need to use their arms repeatedly like volleyball.


Thoracic outlet syndrome
BruceBlaus, CC BY-SA 4.0, via Wikimedia Commons

What are the symptoms of TOS?

TOS is of many types and there can be different symptoms for every type. The most common signs are a pain in the neck, shoulder, or fingers. But sometimes doctors cannot determine whether it is TOS or not. Angina has also created pain in the chest so it might be confused with TOS.

The simple solution of making a difference in both is to start walking when you feel this pain. If you feel an increment in pain when you are walking then, it must be angina. Otherwise, it a condition of TOS. On the other hand, if you feel pain when you raise your arms in the air, then it is TOS, not angina. Mostly, the TOS affects nerves, but it can also affect arteries to some extent. As told earlier that symptoms are different for different types of TOS. So here is a brief discussion about different TOS types with the related signs.

Neurological TOS

if you have issues in the soft tissues of the lower neck area that irritates the nerves and compresses them, then you are facing neurological TOS disorder. These nerves provide the power of movement to hands and arms.

Symptoms of neurological TOS

you may experience weakness in the neck, chest, and arms. Moreover, the muscles of the hands will be affected, and you may feel pain on either side of the body.

Vascular TOS

when the veins are compressed under the collarbone, then vascular TOS occurs. You need to visit your doctor if you are having the following signs.

Symptoms of Vascular TOS

the color of your hands may change, blood clots may result in swelling of the arm, cold arms, tingling in fingers, and weakness of one or two fingers or even the entire hand. Blood clots and arm fatigue are the common signs of vascular TOS.

What causes TOS?

In the above discussion, you might say that TOS happens due to the compression of blood vessels between the collarbone and first rib that creates irritation and pain in the neck and chest. But there might be some other causes of this disorder as well, which are as follows.

  • Inherited: sometimes a TOS can occur when you get an extra rib above your first rib at the time of birth.
  • Sleep disorders: if you are not having an adequate amount of sleep every day, means that sleep hours are needed for the body, then you can be entangled into TOS.
  • Sports activity:  if you are an athlete where you must make repetitive movements with your hands and arm, then you can suffer from TOS disorder more quickly than those who do not participate in sports.
  • Obesity:  if you have gained a lot of weight, then it is possible that your joints cannot hold this weight and due to overpressure, you suffer from TOS.
  • Pregnancy: the signs of TOS may be found in women when they are in pregnancy because in this period joints become loose.
  • Trauma: if you are facing any depression or trauma like accidents, then some changes in your body are observed, which also include compression of the blood vessels.

How is it diagnosed?

If your symptoms are not diagnosed at an early stage, then your nerves can start damaging excessively. You must go to your doctor for a complete physical examination. Some tests performed to diagnose TOS are as follows:

  • Medical history and review of the symptoms to check for TOS.
  • For provoking symptoms, physical movements are evaluated.
  • Study of arteries, veins, and nerves.
  • Chest X-ray for checking the rib disorder.
  • CT Scan and MRI.

By performing the above tests, a doctor can examine the condition of the patient and then go for the proper treatment.

How it can be treated?

If TOS disorder is found at an early stage, then there are more chances of its successful treatment. The treatment depends upon the type and signs of TOS. But before starting the treatment, you need to go to your doctor for knowing the benefits and drawbacks of each treatment.

1. Treatment of neurological TOS:

This type consists of three levels. Generally, it is handled in the first two but in worse cases, the third level is applied. These levels are as follows:

2. Treatment of vascular TOS:

The goal of this treatment is to reduce the risk of blood clots. It consists of the following:

  • Thrombolytic medication that is used to dissolve blood clots.
  • Anticoagulant medication that decreases the power of blood clots and prevents further blood clots.
  • Surgery, which can be essential with medication, to successfully treat the TOS.

TOS can prove to be a serious disorder and can damage your nerves. If you detect any of the above-mentioned signs, then you should go to your doctor for a checkup and treatment. In this way, you can get treatment without any complications and can heal yourself in time.

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