The term “thoracic outlet syndrome” doesn’t refer to a specific injury; rather, thoracic outlet syndrome (TOS) is the name of several diseases and conditions which can affect the thoracic outlet. Most often, the general term “thoracic outlet syndrome” refers to neurogenic thoracic outlet syndrome, a condition which is caused by a compression of nerves called the brachial plexus. If left untreated, neurogenic TOS can lead to numbness in the arms and hands, pain in the shoulder, and a general weakening of muscles.
At the Thoracic Outlet Surgery Center of Excellence, our thoracic surgeons can identity and treat the three various forms of thoracic outlet syndrome, and can work with patients before, during, and after surgery to ensure the best results. To contact one of our thoracic specialists, please call us today at 888.336.0998.Contact Us Now!
Causes of Neurogenic Thoracic Outlet Syndrome
The most common form of thoracic outlet syndrome, neurogenic TOS is caused when the brachial plexus is compressed, leading to various amounts of pain and discomfort in the shoulder area. Roughly 95% of patients with thoracic outlet syndrome have the neurogenic form of the disorder. Located in the thoracic outlet, the brachial plexus is a network of nerve fibers originating from the spinal cord. These nerves supply motor and sensory function to the arms and hands, providing us with the ability to move and feel our arms. When the brachial plexus is compressed, patients report feeling the following symptoms:
- Numbness in the arms and hands
- Pain in the shoulders, neck, and head
- Weakened muscles
Though women are more commonly affected by neurogenic TOS than men, the condition is relatively common among both genders, all ages, and can stem from a variety of causes. Learn more about how neurogenic thoracic outlet syndrome is tested and diagnosed on our testing and diagnosis page. The causes of neurogenic thoracic outlet syndrome include the following:
In some cases, congenital conditions can raise the risk of developing neurogenic TOS. Defects that can lead to the condition include an extra rib above the first rib or a tight fibrous band connecting the rib to the spine. An extra rib can decrease the overall size of the thoracic outlet, leading to easier compression of the brachial plexus contained within.
Poor posture can easily lead to the development of neurogenic TOS. Slouching, hunching, or holding your head forward can cause compression within the thoracic outlet. As a preventative measure, it’s encouraged that patients maintain good posture in order to decrease the risk of developing neurogenic TOS.
Traumatic injuries can internally damage the thoracic outlet and compress the brachial plexus. Car accidents or shoulder injuries can cause changes that lead to the development of neurogenic TOS, though the onset of symptoms are often delayed.
Similar to carpel tunnel syndrome, repetitive activity can lead to the onset of neurogenic TOS. People who work a job requiring repeating movements (such as stocking or lifting) are at a higher risk of developing the condition that others. In addition, certain athletes who perform repetitive movements can develop the syndrome as well (such as pitchers and swimmers).
People who are overweight suffer higher pressure on their joints. This excess weight can also cause compression of the thoracic outlet. Losing weight can help alleviate the risks of developing neurogenic TOS.
Pregnant mothers may experience the onset of neurogenic TOS during pregnancy, specifically because of how the joints loosen during pregnancy.
Treatment for Neurogenic Thoracic Outlet Syndrome
Though neurogenic TOS can be treated through surgery, many surgeons recommend trying conservative treatments first, like physical therapy. If the condition still persists or worsens during physical therapy, surgeons may choose to perform thoracic outlet surgery.
Video-assisted thoracoscopic sympathectomy (also known as VATS) is a minimally invasive surgery used to treat neurogenic thoracic outlet syndrome. The procedure involves the insertion of small, high-tech video cameras into a patient. These cameras transmit a live video feed to monitors in the operation room, which surgeons can view throughout the entire surgery. During VATS, surgeons resection a small portion of the patient’s first rib, relieving pressure on the brachial plexus and providing patients with relief from the symptoms associated with neurogenic TOS.
Contact a Thoracic Expert Today
At the Thoracic Outlet Surgery Center of Excellence, our thoracic surgeons are experts in identifying and treating neurogenic thoracic outlet syndrome. Using a combination of state-of-the-art technology and years of training, our surgeons can help stop neurogenic TOS once and for all. If you experience numbness or a tingling sensation in the arms, pain in your shoulders and neck, and a weak grip, you may have neurogenic TOS. If you would like to schedule a consultation with one of our doctors, contact us by calling 888.336.0998.
Next, read about Vascular Thoracic Outlet syndrome.