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Thoracic Outlet Syndrome

The thoracic outlet is the space between the collarbone and the first rib. Thoracic outlet syndrome (TOS) occurs when blood vessels in the lower neck/upper chest are compressed. This can cause pain, numbness and impaired circulation to areas that have restricted pathways. Thoracic outlet syndrome often is caused by physical trauma, joint pressure, posture, pregnancy or anatomical defects.

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, arms and hands -- is compressed. This can lead to weakness, numbness or pain in the arm or hand.
  • Venous thoracic outlet syndrome occurs when veins and/or arteries in the chest and lower back are compressed. Typically, swelling will occur in the arms, hands and fingers.
  • Arterial thoracic outlet syndrome is caused by an aneurysm in the subclavian artery that can migrate to hands. When this happens, hands feel cold and painful.

Medical and Surgical Treatment Options

The University of Chicago Medicine vascular surgery team offers a wide range of treatment options for patients suffering from thoracic outlet syndrome. Our specialists will explain the treatments available and will work with you to decide on the best option for your condition and lifestyle.

For some patients, undergoing physical therapy can release the compression on blood vessels. Additionally, medications, such as anti-inflammatories, muscle relaxants, thrombotics and pain medication may also be used to manage some patients condition and alleviate symptoms.

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 and will discuss any recommended procedure with you in detail so you can feel confident in your care.


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