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Thoracic Outlet Syndrome

What Is Thoracic Outlet Syndrome?

Thoracic outlet syndrome occurs when blood vessels or nerves become pinched or compressed between the clavicle (collarbone) and the first rib, leading to pain in the shoulders and neck or numbness in the fingers.

Learn more about the signs and symptoms of thoracic outlet syndrome, along with preventative steps, and the treatments we offer to help get you back to normal life.

Causes of Thoracic Outlet Syndrome

Thoracic outlet syndrome is often caused by injury, such as a car accident or job- or sports-related activities. Physical therapy and surgery may be used to relieve symptoms caused by thoracic outlet syndrome.

Signs & Symptoms of Thoracic Outlet Syndrome

Since there are both blood vessels and nerves that pass through the narrow space between the clavicle and first rib, thoracic outlet syndrome may be vascular, neurological, or both. Symptoms vary depending on which structures are affected.

When nerves are compressed, signs and symptoms include:

  • Numbness or tingling in the arm or fingers
  • Pain or achiness in the neck, shoulder, or hand
  • Weakened grip
  • Muscle atrophy in the base of the thumb (Gilliatt-Sumner hand)


When blood vessels are compressed, signs and symptoms include:

  • Bluish discoloration or paleness in the hand or fingers
  • Arm pain and swelling
  • Blood clots in the upper body
  • Weak or no pulse in the affected arm
  • Arm fatigue, especially with exertion
  • Coldness, numbness, or tingling in the arms, hands, or fingers
  • Throbbing near the collarbone
  • Weakness in the arm or neck


Risk Factors

Risk factors for thoracic outlet syndrome include:

  • Age (most common in 20- to 40-year-olds)
  • Sex (more common in females)
  • Pregnancy
  • Anatomical defects (such as an extra rib)


Prevention of Thoracic Outlet Syndrome

There are several behavioral and lifestyle measures that can help prevent thoracic outlet syndrome:

  • Avoid repetitive movements and lifting heavy objects if you’re susceptible to thoracic outlet compression
  • Maintain a healthy body weight
  • Avoid carrying heavy bags over your shoulder
  • Stretch daily, especially the chest, neck, and shoulders
  • Exercise your shoulder muscles


Treatment of Thoracic Outlet Syndrome

Your doctor may use a variety of techniques to diagnose thoracic outlet syndrome, including a physical exam, X-ray or CT scan, ultrasound, angiogram, or other methods. Symptoms and diagnostic methods can vary since thoracic outlet syndrome may present differently from person to person.

At Vascular & Interventional Specialists, we offer minimally invasive surgeries to treat thoracic outlet syndrome and help relieve symptoms:

  • Rib resection – Rib resection is the surgical removal of an extra rib or portion of the first rib to give your thoracic outlet additional room.
  • Sympathectomy – During a sympathectomy, your surgeon clamps the sympathetic nerve, preventing pain signals from reaching the brain, relieving pain and symptoms from nerve-based thoracic outlet syndrome.


Complications of Thoracic Outlet Syndrome

If left untreated, thoracic outlet syndrome can lead to permanent neurological damage. Screening and diagnosis for thoracic outlet syndrome are the best way to determine the possibility of treatment. It’s important if you are experiencing any signs or symptoms to seek help to increase the chance of success through treatment.

Dr. Neal Khurana

Dr. Neal Khurana specializes in treatment and care for chronic venous disease. He is a board-certified and fellowship-trained interventional radiologist experienced in a variety of conditions and endovascular treatments.

Contact us or call 605-217-5617 to schedule an appointment.

Next Steps

VIS is here to help. If you are at risk for aortic disease or have experienced one or more of the signs & symptoms, please reach out to schedule a screening. We’ll walk this journey with you.