Thoracic Outlet Syndrome

Thoracic outlet syndrome is a combination of pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collar bone.

Thoracic outlet syndrome is a rare condition. Blood vessels and nerves coming from the spine or major blood vessels of the body pass through a narrow space near the shoulder and armpit on their way to the arms. As they pass by or through the collarbone (clavicle) and upper ribs, they may not have enough space. Pressure (compression) on these blood vessels or nerves can cause symptoms in the arms or hands. Problems with the nerves account for almost all cases of thoracic outlet syndrome.

Compression can be caused by an extra cervical rib (above the first rib) or an abnormal tight fibrous band connecting the spinal vertebra to the rib. Patients often have a history of injury to the area or overuse of the shoulder.

Symptoms:

Symptoms of thoracic outlet syndrome may include:

• Pain, numbness, and tingling in the last three fingers and inner forearm
• Pain and tingling in the neck and shoulders (carrying something heavy may make the pain worse)
• Signs of poor circulation in the hand or forearm

• Weakness of the muscles in the hand

Treatment:

Physical therapy helps strengthen the shoulder muscles, improve range of motion, and promote better posture. Treatment may also include pain medication.

Surgery may be recommended if physical therapy and changes in activity do not improve your symptoms. Types of procedures that might be performed include:

• An extra rib is removed and certain muscles are cut.
• A section of the first rib is removed to release pressure in the area.
• Bypass surgery is done to reroute blood around the compression or remove the area that is causing the symptoms.

Texas Health is committed to providing quality care to heart and vascular patients throughout North Texas and beyond. While various technologies and services are discussed here, not all of our hospitals offer every treatment and diagnostic technology highlighted. Call 1-877-THR-WELL to learn more about heart and vascular services at a Texas Health hospital near you.