[{"@context":"https:\/\/schema.org\/","@type":"Article","@id":"https:\/\/share-dev.upmc.com\/2016\/08\/thoracic-outlet-syndrome-symptoms\/#Article","mainEntityOfPage":"https:\/\/share-dev.upmc.com\/2016\/08\/thoracic-outlet-syndrome-symptoms\/","headline":"Thoracic Outlet Syndrome: Types, Causes, Symptoms, and Treatment","name":"Thoracic Outlet Syndrome: Types, Causes, Symptoms, and Treatment","description":"Learn about thoracic outlet syndrome (TOS) and how to tell if your arm pain is a sign of a more serious health problem.","datePublished":"2016-08-22","dateModified":"2022-03-21","author":{"@type":"Organization","@id":"https:\/\/www.upmc.com\/services\/heart-vascular","name":"Heart and Vascular Institute","url":"https:\/\/www.upmc.com\/services\/heart-vascular","sameAs":"https:\/\/share-dev.upmc.com\/heart-and-vascular-institute\/","parentOrganization":"UPMC"},"publisher":{"@type":"Organization","name":"UPMC HealthBeat","logo":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2019\/04\/UPMC-HealthBeat-Logo.png","width":600,"height":60}},"image":{"@type":"ImageObject","@id":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2016\/08\/Thoracic-Outlet-Syndrome-Symptoms.jpg","url":"https:\/\/share-dev.upmc.com\/wp-content\/uploads\/2016\/08\/Thoracic-Outlet-Syndrome-Symptoms.jpg","height":326,"width":753},"url":"https:\/\/share-dev.upmc.com\/2016\/08\/thoracic-outlet-syndrome-symptoms\/","about":["Heart and Vascular Health"],"wordCount":577,"keywords":["angina","arm pain","heart attack","thoracic outlet syndrome","TOS"],"articleBody":"Many health conditions can cause pain, tingling, or numbness in your neck, chest, arms, and hands, from\u202fminor muscle strains\u202fto a serious problem like a\u202fheart attack.While thoracic outlet syndrome (TOS) is not life-threatening, it can lead to disability and complications if left untreated.Find out about the types of TOS, common symptoms, and who is at risk.What is Thoracic Outlet Syndrome?The thoracic outlet is the space where arteries, veins, and nerves travel through the upper chest. TOS describes a group of conditions that occur when these blood vessels or nerves are compressed.TOS most often affects:Athletes who participate in activities with repetitive overhead motion (pitchers, swimmers, volleyball players, tennis players, weightlifters).Jobs with repetitive overhead activity (pharmacists, electricians).People with previous neck trauma, shoulder injuries or a broken collarbone.Teenagers.Anyone of any age and gender may develop TOS, and it\u2019s generally more common in women than men.Thoracic Outlet Syndrome Types and CausesNeurogenic thoracic outlet syndromeMost common type, representing more than 90% of TOS patients.Caused by compression of the brachial plexus \u2013 the network of nerves in the thoracic outlet \u2013 often due to a previous injury, trauma, or repetitive motions .Venous thoracic outlet syndromeCaused by compression of the subclavian vein\u2013 which brings blood from your arm back to your heart \u2013 possibly due to repeated strenuous use of the shoulder and arm.Arterial thoracic outlet syndromeLeast common type.Caused by compression of the subclavian artery – which provides blood to the arm – possibly due to an abnormal or extra first rib.Thoracic Outlet Syndrome SymptomsSymptoms of this condition can depend on which type of TOS you have.Neurogenic thoracic outlet syndromeArm\/hand fatigue, numbness, tingling.Headaches in the back of the head.Neck pain.Pain from shoulder to fingertips.Venous thoracic outlet syndromeArm fatigue, heaviness, and swelling.Blue discoloration.Dilated veins in arm and chest.Arterial thoracic outlet syndromeArm\/hand coolness or fatigue.Cold intolerance.Cramping.Discoloration of the fingernail bed.Thoracic Outlet Syndrome TreatmentTreatment options depend on the type of TOS. In all cases, early diagnosis is helpful and improves outcomes. The goals of treatment are alleviating your symptoms and improving your quality of life.Arterial TOS often requires the greatest need for surgical repair due to the risk of blood clots migrating to the arm and hand. Early medication may be needed to dissolve clots, and additional imaging is routinely used to determine if the subclavian artery needs to be repaired or replaced.Venous TOS also is initially managed with clot-dissolving medication to lower the risk of pulmonary emboli. Once the clot has been effectively treated, your surgeon may discuss removing the first rib and a muscle before repairing the narrowed vein to prevent future recurrence.Only 20% to 30% of neurogenic TOS patients require surgery. It is routinely managed with physical therapy focusing on posture reconditioning, shoulder and neck range of motion, and strengthening core back muscles. Patients who don\u2019t respond to these treatments may require removal of ribs or muscles that are compressing the nerves.Surgery is highly effective for alleviating symptoms and providing durable results for arterial and venous TOS. Neurogenic TOS surgery can be very effective, but it is associated with a 22% rate of recurrence in the lifetime of the patient due to the chronic repetitive nature of an individual\u2019s occupation. Editor's Note: This article was originally published on August 22, 2016, and was last reviewed on March 21, 2022."},{"@context":"https:\/\/schema.org\/","@type":"BreadcrumbList","itemListElement":[{"@type":"ListItem","position":1,"name":"2016","item":"https:\/\/share-dev.upmc.com\/2016\/#breadcrumbitem"},{"@type":"ListItem","position":2,"name":"08","item":"https:\/\/share-dev.upmc.com\/2016\/\/08\/#breadcrumbitem"},{"@type":"ListItem","position":3,"name":"Thoracic Outlet Syndrome: Types, Causes, Symptoms, and Treatment","item":"https:\/\/share-dev.upmc.com\/2016\/08\/thoracic-outlet-syndrome-symptoms\/#breadcrumbitem"}]}]