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Thoracic outlet syndrome (TOS) is a time period used to describe a gaggle of issues that occur when there may be compression, injury, or irritation of the nerves and/or blood vessels (arteries and veins) in the lower neck and upper chest area. Thoracic outlet syndrome is named for the space (the thoracic outlet) between your lower neck and upper chest the place this grouping of nerves and blood vessels is found.

Who's affected by thoracic outlet syndrome?

Thoracic outlet syndrome affects folks of all ages and gender. The condition is widespread amongst athletes who participate in sports that require repetitive motions of the arm and shoulder, such as baseball, swimming, volleyball, and other sports.

Neurogenic TOS is the most typical form of the dysfunction (ninety five p.c of people with TOS have this form of the dysfunction) and usually impacts middle-aged women.

Latest research have shown that, on the whole, TOS is more widespread in women than men, particularly amongst these with poor muscular development, poor posture or both.

The signs and signs of TOS embody neck, shoulder, and arm pain, numbness or impaired circulation to the affected areas.

The pain of TOS is sometimes confused with the pain of angina (chest pain due to an inadequate supply of oxygen to the guts muscle), however the two conditions could be distinguished because the pain of thoracic outlet syndrome does not happen or increase when walking, while the pain of angina normally does. Additionally, the pain of TOS typically increases when elevating the affected arm, which does not occur with angina.

Signs and signs of TOS help decide the type of dysfunction a patient has. Thoracic outlet syndrome problems differ, relying on the part(s) of the body they affect. Thoracic outlet syndrome most commonly affects the nerves, however the condition can even affect the veins and arteries (least widespread type). In all types of TOS, the thoracic outlet area is narrowed, and there is scar formation around the structures.

Types of thoracic outlet syndrome issues and related symptoms

Neurogenic thoracic outlet syndrome: This condition is expounded to irregularities of bony and soft tissue in the lower neck area (which could include the cervical rib area) that compress and irritate the nerves of the brachial plexus, the complex of nerves that offer motor (movement) and sensory (feeling) perform to the arm and hand. Symptoms embody weakness or numbness of the hand; decreased dimension of hand muscles, which normally happens on one side of the body; and/or pain, tingling, prickling, numbness and weakness of the neck, chest, and arms.

Venous thoracic outlet syndrome: This condition is caused by damage to the major veins in the lower neck and higher chest. The condition develops all of the sudden, typically after unusual and tiring train of the arms. Symptoms embody swelling of the arms, fingers and arms, as well as heaviness and weakness of the neck and arms. The veins within the anterior (entrance) chest wall veins also could seem dilated (swollen).

Arterial thoracic outlet syndrome: The least common, but most severe, type of TOS is caused by congenital (present at birth) bony irregularities in the lower neck and upper chest. Signs embrace cold sensitivity within the arms and fingers; numbness, pain or sores of the fingers; and poor blood circulation to the arms, palms and fingers.

What causes thoracic outlet syndrome?

The issues caused by TOS will not be well understood. But, it is known that when the blood vessels and/or nerves in the tight passageway of the thoracic outlet are abnormally compressed, they develop into irritated and can cause TOS. Thoracic outlet syndrome could be a results of an additional first rib (cervical rib) or an old fracture of the clavicle (collarbone) that reduces the area for the vessels and nerves. Bony and soft tissue irregularities are among the many different causes of TOS. The following may improve the risk of creating thoracic outlet syndrome:

Sleep problems

Tumors or giant lymph nodes in the higher chest or underarm space

Stress or depression

Participating in sports that involve repetitive arm or shoulder movement, corresponding to baseball, swimming, golfing, volleyball and others

Repetitive injuries from carrying heavy shoulder loads

Injury to the neck or back (whiplash injury)

Poor posture

Weightlifting

How is thoracic outlet syndrome handled?

Early identification of TOS will help improve the success of treatment. Thoracic outlet syndrome deal withments fluctuate, depending on the type of TOS you may have and your symptoms. The goals of deal withment are to reduce symptoms and pain. Your health care provider will recommend the deal withment option that's proper for you.

Before choosing any treatment, it is important to talk to your health care provider in regards to the potential benefits, risks and side effects of your deal withment options.

Treatment of neurogenic thoracic outlet syndrome

Physical therapy: The commonest initial treatment for neurogenic thoracic outlet syndrome is physical therapy. Physical therapy increases the range of motion of the neck and shoulders, strengthens muscles and promotes better posture. Most patients expertise an improvement in symptoms after undergoing physical therapy.

Drugs: For pain relief, over-the-counter pain drugs, akin to aspirin, acetaminophen (Tylenol), or ibuprofen (Motrin), may be recommended. Your physician might prescribe a muscle relaxant for additional pain relief.

Surgery: In some cases, surgery could also be needed to treat neurogenic thoracic outlet syndrome if symptoms continue, despite an optimum course of physical therapy.

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