Thoracic Outlet Syndrome
Thoracic Outlet Syndrome
|Thoracic Outlet Syndrome|
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- True neurologic TOS—caused by birth defects of vessels and nerves in the lower neck and upper chest.
- Arterial TOS—caused by birth defects of blood vessels in the lower neck and upper chest. There is no nerve damage or injury in this area.
- Venous TOS—exact cause is unknown. It is thought to be due to blockage the veins that drain the arm.
- Traumatic TOS—damage to vessels and nerves caused by an injury, such as a car accident.
- Disputed TOS (Common or Non-specific TOS)—cause is unknown, but may be related to accident or injury.
True neurologic TOS will only have symptoms on one side of the body including:
- Hand weakness
- Raynaud’s phenomena (changing of the color of the limb when exposed to cold)
- Decreased size of hand muscles
Arterial TOS may cause:
- Cold sensitivity in the hands and fingers
- Pain or sores of the fingers
- Poor blood circulation to the arm, hands, and fingers
Venous TOS symptoms develop suddenly, often after a tiring arm exercise. Symptoms may include:
- Swelling of the limb
- Skin of arm turning pale and blue
- May be tingling of the fingers
Traumatic TOS symptoms include:
- Pain and tingling and pricking of the neck, chest, and arms
- Numbness and weakness
Disputed TOS symptoms include:
- Pain in the upper extremity
- Muscle weakness
- Sagging muscles related to aging
- Being obese
- Having heavy breasts
- Repetitive injuries that come with carrying heavy weights
- Repeatedly reaching overhead
- Lifting objects with the arms extended above shoulder level.
National Institute for Neurological Disorders and Stroke http://www.ninds.nih.gov/
The Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT) http://www.nismat.org/
The Spinal Injury Foundation http://www.spinalinjuryfoundation.org/
Canadian Centre for Occupational Health and Safety (CCOHS) http://www.ccohs.ca/
The Association for Repetitive Motion Syndromes (ARMS) http://www.certifiedpst.com/arms/index.html/
Crotti FM, Carai A, Carai M, et al. TOS pathophysiology and clinical features. Acta Neurochir Suppl . 2005;92:7-12.
Huang JH, Zager EL. Thoracic outlet syndrome. Neurosurgery . 2004;55:897-902.
Nord KM, Kapoor P, Fisher J, et al. False positive rate of thoracic outlet syndrome diagnostic maneuvers. Electromyography Clinical Neurophysiology. 2008;48:67-74.
Sanders RJ, Hammond SL, Rao NM. Diagnosis of thoracic outlet syndrome. J Vasc. Surg . 2007;46:601-604.
Surgery for thoracic outlet syndrome (TOS). Washington State Department of Labor and Industries website. Available at: http://www.guideline.gov/ . Accessed July 26, 2005.
Wehbe M, Leinberry C. Current trends in treatment of thoracic outlet syndrome. Hand Clin . 2004;20:119-121.
- Reviewer: Rimas Lukas, MD
- Review Date: 09/2012 -
- Update Date: 09/26/2012 -