what are the three types of thoracic outlet syndrome

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What are the 3 types of TOS?

What are the types of thoracic outlet syndrome?Neurogenic TOS occurs when the nerves leading from the neck to the arm (the brachial plexus) is compressed. ... Venous TOS occurs when a vein is compressed, leading to upper body thrombosis. ... Arterial TOS occurs when an artery is compressed.

Where is pain with thoracic outlet syndrome?

Thoracic outlet syndrome is a painful condition that results from compression of the nerves and/or blood vessels running through the thoracic outlet (area between the top rib and collarbone). The symptoms are typically felt in the shoulder and arm, but sometimes can also be felt in the neck.

What happens if thoracic outlet syndrome goes untreated?

If left untreated, thoracic outlet syndrome can lead to serious complications, such as blood clots or pulmonary embolism, a life-threatening condition that happens when a blood clot travels to your lungs and suddenly blocks blood flow. Thoracic outlet syndrome can also cause permanent nerve damage.

What mimics thoracic outlet syndrome?

Pectoralis minor syndrome (PMS) is a condition causing pain, numbness and tingling in the hand and arm. It often coexists with thoracic outlet syndrome (TOS) but can also occur alone. The symptoms are similar to those of TOS: Pain, weakness, numbness and tingling in the hand and arm.

Does thoracic outlet syndrome show up on MRI?

Conclusion: MRI can contribute to the diagnosis of TOS. Specificity is sufficiently high to provide guidance for planning the surgical procedure. Sensitivity, however, is too low for MRI to be useful as a screening test.

Why is thoracic outlet syndrome worse at night?

As the pressure gets relieved from the nerves, the "pins and needles" feeling is felt. Just like when someone sits with his/her legs crossed too long and goes to stand up; the rush of sensation can be very intense. With more pressure from activity during the day, the sensations become worse at night.

How serious is TOS surgery?

Surgery for venous and arterial TOS is very effective. Among patients with venous TOS, elective surgery corrects symptoms in 90 to 95 percent of cases; elective surgery resolves symptoms in more than 95 percent of patients with arterial TOS. Some patients with neurogenic TOS will need surgery.

Is TOS a disability?

Because TOS is an unlisted disability, you may need the help of a Pittsburgh disability attorney to obtain your benefits.

How long is physical therapy for thoracic outlet syndrome?

Physical Therapy Pre-Operative Conservative Management Usually a 6-8-week trial of physical therapy with emphasis on strengthening, shoulder range of motion, and pain relief techniques. Therapy should avoid exacerbation of symptoms.

Can a neurologist diagnose thoracic outlet syndrome?

How is thoracic outlet syndrome diagnosed? Your medical team at The Lung Center will collaborate with a neurologist to evaluate your symptoms. Your medical team will perform a complete physical examination in order to find any outward signs of thoracic outlet syndrome, such as swelling or discoloration.

Can TOS cause a stroke?

Although arterial TOS is the least common form of TOS, far behind neurogenic TOS, its complication can be the most devastating. Neurogenic TOS can result in chronic loss of neurologic function, venous TOS in local vein thrombosis. But arterial TOS can lead to limb ischemia or cerebral stroke.

What are two special tests that can help diagnose the presence of TOS?

Invasive arteriography and angiography are for detecting complications of ATOS such as thrombosis, embolisation, and aneurysm. Due to the invasive nature of these investigations, they are usually employed as part of surgery planning rather than diagnosis alone.

What does thoracic nerve pain feel like?

Individuals with a thoracic pinched nerve often experience some of the following symptoms: Pain in the middle of the back. Pain that radiates to the front of the chest or shoulder. Numbness or tingling that extends from the back into the upper chest.

What does thoracic pain feel like?

Thoracic back pain can feel like: Sharp pain localised to one spot either on the spine or to one side. General ache or throbbing pain affecting a wider area. A stiffness causing a loss of normal movement.

What does brachial plexus pain feel like?

Common symptoms of brachial plexus injuries are: Numbness or loss of feeling in the hand or arm. Inability to control or move the shoulder, arm, wrist or hand. An arm that hangs limply.

Can thoracic outlet syndrome cause armpit pain?

Some symptoms of neurogenic thoracic outlet syndrome include: pain or a dull aching in the neck, shoulder, armpit, arm, or hand.

What is the most common type of thoracic outlet syndrome?

There are a number of types of thoracic outlet syndrome, including: Neurogenic (neurological) thoracic outlet syndrome. This most common type of thoracic outlet syndrome is characterized by compression of the brachial plexus. The brachial plexus is a network of nerves that come from your spinal cord and control muscle movements ...

How to treat thoracic outlet syndrome?

Treatment for thoracic outlet syndrome usually involves physical therapy and pain relief measures. Most people improve with these approaches. In some cases, however, your doctor may recommend surgery.

What age is thoracic outlet syndrome most common?

Age. Thoracic outlet syndrome is more common in young adults, between 20 and 40 years old.

What is the thoracic outlet?

Thoracic outlet. Thoracic outlet. The thoracic outlet is the space between your collarbone (clavicle) and your first rib. This narrow passageway is crowded with blood vessels, nerves and muscles. Thoracic outlet syndrome is a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib ...

What causes a compression in the thoracic outlet?

Poor posture. Drooping your shoulders or holding your head in a forward position can cause compression in the thoracic outlet area. Trauma. A traumatic event, such as a car accident, can cause internal changes that then compress the nerves in the thoracic outlet.

Can thoracic outlet syndrome be caused by repetitive movements?

Athletes, such as baseball pitchers and swimmers, also can develop thoracic outlet syndrome from years of repetitive movements. Pressure on your joints. Obesity can put an undue amount of stress on your joints, as can carrying around an oversized bag or backpack. Pregnancy.

Is thoracic outlet syndrome a common disorder?

Some doctors don't believe it exists, while others say it's a common disorder. People with nonspecific-type thoracic outlet syndrome have chronic pain in the area of the thoracic outlet that worsens with activity, but a specific cause of the pain can't be determined.

What are the three primary structures that pass through each thoracic outlet?

Specifically, the three primary structures that pass through each thoracic outlet are an artery, a vein and a nerve plexus. Thus, the three classic types of TOS are arterial TOS, venous TOS, and neurogenic TOS. To clarify, each of the three types of TOS is defined by the vital structure that is compressed in the thoracic outlet:

How many types of TOS are there?

For the purposes of learning about the three major types of TOS, we will discuss each type of TOS separately. Following that discussion, we will go over how a patient can develop multiple types of TOS.

What is the most common type of TOS?

Neurogenic TOS is by far the most common type of TOS. At the same time, neurogenic TOS is the most difficult type of TOS to diagnose. Patients often cycle through many doctors, and many specialities, before they receive the correct diagnosis.

Where does neurogenic TOS occur?

Neurogenic TOS occurs through the same process, but is much more complex than entrapment of a single peripheral nerve. In detail, five nerve roots arise from the spinal cord on each side of the neck. After leaving the spinal cord, these nerve roots enter the thoracic outlet.

Can neurogenic TOS cause compression of the subclavian vein?

In fact, many patients with neurogenic TOS also have compression of the subclavian vein, but without a blood clot.

Can multiple types of thoracic outlet syndrome occur in the same patient?

Yes! One patient can have multiple types of TOS at the same time. As shown above, the artery, vein, and brachial plexus pass through each thoracic outlet together. In addition, the mechanism of compression is similar for all types of TOS. Thus, a patient can have compression of 1, 2, or all 3 of these vital structures. In fact, many patients with neurogenic TOS also have compression of the subclavian vein, but without a blood clot. In that case, compression may impair venous drainage of the arm. As a result, swelling or edema of the arm can result. This swelling can magnify compression of the brachial plexus. In that case, treatment to relieve the venous compression helps relieve compression on the brachial plexus.

What is the best treatment for thoracic outlet syndrome?

If medical treatment alone does not improve your symptoms, surgery may be the next step. Our vascular surgeons are highly skilled in treating thoracic outlet syndrome ...

What is the term for a thoracic outlet?

Thoracic Outlet Syndrome. The thoracic outlet is the space between the collarbone and the first rib, and if any of the vessels or nerves in that area are damaged (known as thoracic outlet syndrome), patients can experience pain or numbness.

What are the different types of TOS?

Types of Thoracic Outlet Syndrome. There are three distinct types of TOS, and the symptoms vary depending on the specific diagnosis and afflicted body part. Neurogenic thoracic outlet syndrome results when the brachial plexus — nerves in the spinal cord that correspond with muscle control and sensation in the shoulders, ...

What Causes Thoracic Outlet Syndrome?

Most often, thoracic outlet syndrome develops from a combination of the way your body is built and frequent motions of the area. The thoracic outlet is a narrow space, where compression can easily occur. Sometimes, the space is too narrow for nerves and blood vessels to travel smoothly through this space between the upper ribs and collarbone.

What is a thoracic outlet?

Definition. Thoracic outlet syndrome is a rare condition that involves: Pain in the neck and shoulder. Numbness and tingling of the fingers. A weak grip. Swelling of the affected limb. Coldness of the affected limb.

What causes a tight band in the arm?

Pressure ( compression) on these blood vessels or nerves can cause symptoms in the arms or hands. Pressure may happen if you have: An extra rib above the first one. An abnormal tight band connecting the spine to the ribs. People with this syndrome often have injured the area in the past or overused the shoulder.

How to prevent blood clots in shoulder?

Your provider may prescribe pain medicine. If there is pressure on a vein, your provider may give you a blood thinner to prevent a blood clot. You may need surgery if physical therapy and changes in activity do not improve your symptoms.

Where is the thoracic outlet?

The thoracic outlet is an area of the body located within the lower part of the neck, beginning just above and behind the clavicle and overlying the first rib, and extending to the upper part of the arm. Thoracic Outlet Syndrome (TOS) is a general term used to describe conditions caused by compression of the major nerves and/or blood vessels in ...

What are the symptoms of neurogenic TOS?

Patients with neurogenic TOS often have gradual development of symptoms that include pain, numbness, and tingling in the arm or hand, particularly with activity or in elevated positions of the arm, which can progress to become disabling. 85-95% of all patients with TOS are affected by neurogenic TOS. Venous TOS.

What is a TOS?

Thoracic Outlet Syndrome (TOS) is a general term used to describe conditions caused by compression of the major nerves and/or blood vessels in this area. There are three principal types of thoracic outlet syndrome: Neurogenic TOS. Caused by compression of the brachial plexus nerves that serve the entire arm and hand.

What is the treatment for TOS?

Treatment for TOS may include either non-surgical management or surgery. Optimal treatment for all three forms of TOS requires the experience and expertise of health care professionals knowledgeable about these conditions, and a great deal of patience.

Is neurogenic TOS rare?

All three types of TOS are considered rare conditions. The diagnosis of neurogenic TOS is difficult and often elusive, and may involve extensive testing, multiple specialist evaluations, and prolonged attempts at various forms of management.

What are the different types of thoracic outlet syndrome?

There are 3 types of thoracic outlet syndrome: Neurogenic: Affects nerves leading from the spinal cord to the neck to the arm. Most thoracic outlet syndrome cases involve nerves. Venous: Affects veins. Arterial: Affects arteries.

What Is Thoracic Outlet Syndrome?

Thoracic outlet syndrome (TOS) is when you have pain, swelling, or other symptoms from compression in your thoracic outlet -- the opening between your lower neck and upper chest. It can cause numbness and tingling in your arms or pain in your shoulders, especially when you raise your arms.

How long does thoracic outlet decompression work?

This can work for up to 3 months and be repeated if you need it. Surgery is sometimes an option, but it doesn’t work nearly as well for this type of TOS. Venous and arterial: First you’ll be treated for any possible blood clots. Then you’ll most likely need a type of surgery called thoracic outlet decompression.

What age group is most likely to have TOS?

TOS is found more often in women than in men and primarily in young people, mostly ages 20-40. Athletes who move their arms in the same way a lot, like swimmers or baseball pitchers, also can be more likely to have it. Thoracic Outlet Syndrome Diagnosis.

Is thoracic outlet syndrome more serious?

About 95% of thoracic outlet syndrome cases involve nerves. It’s rare but more serious when it affects a vein or an artery. The condition is more common in women. It’s also often seen in athletes and workers who make repeated arm motions.

Overview

• The most common type of the condition, neurogenic thoracic outlet syndrome, is caused by the compression of the brachial plexus, a network of nerves that extend from the spine through the neck and into the arm. It tends to occur in people who perform repetitive overhead arm movements in their job or participate in certain sports, such as swimming o...

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Symptoms

Causes

Risk Factors

Complications

• There are three general types of thoracic outlet syndrome: 1. Neurogenic (neurologic) thoracic outlet syndrome.This most common type of thoracic outlet syndrome is characterized by compression of the brachial plexus. The brachial plexus is a network of nerves that come from your spinal cord and control muscle movements and sensation in your shoulde...

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Prevention