Thoracic outlet syndrome is a group of disorders caused by pressure or compression against the nerves or blood vessels in the space behind and below the collarbone (the thoracic outlet). Thoracic outlet syndrome is more common in women than men and usually starts between 20 and 50 years of age.
There are three main kinds of thoracic outlet syndrome. The classification depends on what is being compressed – a nerve, a vein or an artery.
Ninety-five percent of thoracic outlet syndrome cases are due to compression of nerves to the arm.
Thoracic outlet syndrome can be caused by various things, such as:
Thoracic outlet syndrome affecting a nerve will usually cause the following symptoms:
Thoracic outlet syndrome affecting a vein will usually cause the following symptoms:
Thoracic outlet syndrome affecting an artery will usually cause the following symptoms:
Diagnosing thoracic outlet syndrome can be difficult because the symptoms resemble those of many other disorders and injuries, such as rotator cuff injuries, fibromyalgia, multiple sclerosis, and cervical disc disorders. Your doctor will perform a physical exam and may also use the following tests to help rule out other conditions:
Treatment for thoracic outlet syndrome will vary depending on the type that you have. If your nerves are affected, you’ll be initially treated with physical therapy and medications. Most patients improve after this, but you may need decompression surgery if these measures aren’t enough.
If thoracic outlet syndrome is affecting your veins, the clot will be treated with thrombolysis, blood thinners or angioplasty. In rare cases, the vein may need to be repaired with surgery.
If thoracic outlet syndrome is affecting your arteries, you’ll likely need surgery to repair the damaged artery with a graft.