Thoracic outlet syndrome (TOS) is a condition where the nerves or blood vessels in the thoracic outlet (the space between the collarbone and first rib) are compressed, causing various symptoms.

Common Symptoms

• Pain, numbness, tingling or weakness in the shoulder, arm or hand
• Swelling or discoloration of the arm or hand
• Weakened pulse in the affected arm

Cause & Anatomy

Causes of Thoracic Outlet Syndrome:

• Anatomical variations like an extra cervical rib or abnormally tight muscles
• Trauma or injury to the area
• Repetitive arm motions, poor posture

The thoracic outlet is the space between the collarbone and first rib where the brachial plexus (bundle of nerves), subclavian artery and vein pass from the neck into the arm.

Diagnosis

• Physical exam to check for symptoms with arm movements
• Imaging tests like X-rays, CT or MRI scans
• Electromyography to check for nerve damage

Prevention

• Maintaining good posture
• Avoiding repetitive arm motions or overhead activities
• Ergonomic workstation setup

Treatment

• Physical therapy and exercises
• Medications like muscle relaxants, anti-inflammatories
• Botox injections into tight muscles
• For vascular TOS, blood thinners or clot removal

Surgery

• Removing the first rib, cervical rib or tight muscles compressing the area
• Repairing or bypassing damaged blood vessels for vascular TOS
• Rehabilitation
• Physical therapy is crucial after surgery to regain strength, flexibility and range of motion in the arm and shoulder.