Thoracic outlet syndrome (TOS) is a medical condition that involves the compression or irritation of the nerves, blood vessels, or both, in the thoracic outlet region. The thoracic outlet region is the narrow space between the collarbone (clavicle) and the first rib, where important nerves and blood vessels pass through on their way from the neck to the arms.
The compression or irritation of these structures in the thoracic outlet may occur due to various reasons, such as anatomical abnormalities, trauma, poor posture, repetitive activities, or the presence of an extra rib. This compression or irritation can lead to a range of symptoms, including pain, numbness, weakness, or tingling in the upper extremities, especially in the arm, shoulder, and neck.
There are three main types of thoracic outlet syndrome: neurogenic (most common), arterial, and venous. Neurogenic thoracic outlet syndrome occurs when the nerves are compressed or irritated, resulting in symptoms such as pain, weakness, or tingling in the arm and hand. Arterial thoracic outlet syndrome involves the compression of the arteries, which can lead to decreased blood flow to the arm, causing symptoms like coldness, paleness, or faint pulses. Venous thoracic outlet syndrome occurs when the veins are compressed, leading to swelling, discoloration, or blood clots.
Treatment options for thoracic outlet syndrome may vary depending on the type and severity of the condition. Conservative approaches involve physical therapy, exercises, ergonomic modifications, pain management, and lifestyle adjustments. In more severe cases, surgical intervention may be necessary to relieve compression and restore normal nerve and vascular function.
