Thoracic outlet syndrome – Symptoms, causes & types

Thoracic outlet syndrome

This is a group of disorders that happen when blood vessels or nerves in the space between the collarbone and the first rib (called thoracic outlet) are compressed. This can lead to pain in your shoulders and neck and numbness in your fingers. The most common causes for thoracic outlet syndrome are pregnancy; certain anatomical defects (such as having an extra rib); repetitive injuries from job or sport related activities; physical trauma from a car accident.

There are some cases when doctors cannot determine the cause for the thoracic outlet syndrome. Usually, the treatment for the thoracic outlet syndrome is involving physical therapy and pain relief measures. In the most cases, people improve with these remedies. Also, there are some cases when doctors can recommend surgery for your thoracic outlet syndrome.


Thoracic outlet syndrome

The symptoms of the thoracic outlet syndrome can vary which depends on which structures are compressed. When the nerves are compressed, then the signs and symptoms of thoracic outlet syndrome are next:

  • Weakening grip
  • There can be a pain or aches in your neck, shoulder or hand
  • Numbness or tingling in your arm or fingers
  • There can be muscle wasting in the fleshy base of your thumb (Gilliatt – Sumner hand)
  • Here are the signs and symptoms of the vascular thoracic outlet syndrome:
  • Throbbing lump near your collarbone
  • Weakness of arm or neck
  • Numbness or tingling in your fingers
  • Arm fatigue with activity
  • Cold fingers, hands or arms
  • Weak or no pulse in the affected arm
  • You can have a lack of color (pallor) in one or more of your fingers or your entire hand
  • There can be blood clot in veins or arteries in the upper area of your body
  • You can have arm pain and swelling, possibly due to blood clots
  • Discoloration of your hand (bluish color)

If you constantly experience some of the mentioned signs and symptoms of thoracic outlet syndrome, then you should talk with your doctor as soon as possible.


The cause for the thoracic outlet syndrome is the compression of the nerves or blood vessels in the thoracic outlet which is just under the collarbone (also called clavicle). The cause for the compression can vary and it includes:

Pregnancy: Joints loosen during pregnancy so the signs of the thoracic outlet syndrome can first appear while you are pregnant.

Pressure on your joints: It is known that obesity can put an undue amount of stress on your joints but also the carrying around an oversized bag or backpack can do it.

Repetitive activity: When you are doing the same things repeatedly this can cause wear on your body’s tissue as the time passes. You can notice symptoms of this syndrome if your job requires you to repeat a movement continuously, such as working on an assembly line, typing on computer or you are lifting things above your head, as you would if you were stocking shelves.

Poor posture: Holding your head in a forward position or drooping your shoulders can cause compression in the thoracic outlet area.


There are different types of thoracic outlet syndrome, such as

Nonspecific – type thoracic outlet syndrome: It is also known as disputed thoracic outlet syndrome. There are some doctors who do not believe that it exists while other doctors say that it is a very common disorder. Those people who have this type of syndrome can have a chronic pain in the area of the thoracic outlet which worsens with activity but a specific cause of the pain cannot be determined.

Neurogenic (neurological) thoracic outlet syndrome: This is a type of syndrome which is characterized by compression of the brachial plexus. We know that the brachial plexus is a network of nerves which comes from the spinal cord and it controls muscle movements and sensation in your shoulder, arm and hand. In the most cases, thoracic outlet syndrome is neurogenic.

Vascular thoracic outlet syndrome: This type of syndrome happens when one or more of the veins or arteries  under the collarbone (also called clavicle) are compressed.


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