Causes Of Thoracic Outlet Syndrome: Symptoms & Treatment Options

The thoracic outlet syndrome is a group of disorders which occurs when the nerves or the blood vessels in the space between the first rib and the collarbone get compressed. It manifests as pain in the neck and shoulders along with numbness.

Following are some of the common causes of thoracic outlet syndrome:

  • Anatomical faults: Defects present at birth – such as an extra rib above the first rib or an abnormally tight fibrous band that connects the rib and spine.
  • Bad posture: Slouching and holding the head in a forward position triggers impingement in the thoracic outlet area.
  • Injury: A car accident or any kind of trauma can compress the nerves in the thoracic outlet.
  • Repetitive actions: Doing the same thing over and over again, over time, wears on the body’s tissue – typing at the computer, swimming, lifting things over the head, etc. are common causes.
  • Pressure: Obesity exerts a lot of pressure and stress on the joints.
  • Pregnancy: Joints loosen during pregnancy, thus, signs of thoracic outlet syndrome may first manifest during pregnancy.

Symptoms Of Thoracic Outlet Syndrome

Neurogenic thoracic outlet syndrome is characterized by an impingement of the brachial plexus network of nerves which govern muscle movement and sensation.

By and large, in most cases, the symptoms are neurogenic.

Neurogenic thoracic outlet symptoms include:

  • Tingling numbness in the fingers.
  • Pain in the neck and shoulders.
  • Wasting in the fleshy area of the base of the thumb.
  • Weakening of the grasp Vascular thoracic outlet syndrome develops when the veins or arteries under the collarbone get crushed.

Signs and symptoms of vascular thoracic outlet syndrome include:

  • The hand discolors and turns blue.
  • Blood clots.
  • Pain and swelling in the arm, probably because of blood clots.
  • Lack of color in the hand.
  • Weak or no pulse in the affected arm.
  • Cold fingers, hands or arms.
  • Arm fatigue.
  • Tingling numbness in the fingers.
  • Weakness of the shoulders, arm and neck.
  • A throbbing lump near the collarbone.

Non-specific thoracic outlet syndrome has ambiguous symptoms; they may have chronic pain in the area of the thoracic outlet which aggravates with activity, on the other hand the specific cause of the pain is rather difficult to establish.

Treatment Options For Thoracic Outlet Syndrome

  • Physical therapy: Physiotherapy helps manage the symptoms of pain, stiffness and numbness effectively. Exercises strengthen and stretch the shoulder muscles to open the thoracic outlet, enhance the range of movement and improve posture. Physiotherapy helps take pressure off the nerves and blood vessels in the thoracic outlet.
  • Medications: Analgesics, anti-inflammatory drugs and muscle relaxants are prescribed to manage the agonizing symptoms.
  • Clot dissolving drugs: In case of blood clots, your doctor will administer thrombolytics in to the arteries / veins to dissolve them.
  • Surgery is advocated when other treatments fail. However, surgery may not allay the symptoms, and symptoms are known to recur. The surgery to treat thoracic outlet syndrome is known as thoracic outlet decompression.
  • In general, to make sure that you do not have unnecessary stress on the shoulders and the surrounding muscles, follow these guidelines:
    • Maintain a good posture.
    • Make sure that you take frequent breaks when at work to stretch.
    • Have a good body weight.
    • Massaging the affected area yields wonderful results.
    • Do not carry heavy weight.
    • Steer clear of all activities which aggravate your symptoms.

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