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Painful Arms, Shoulders and Neck: How Much Do You Know about the Alarming Symptoms of Thoracic Outlet Syndrome?
Thoracic Outlet Syndrome (TOS) is a condition caused by compression of nerves, arteries, or veins between the neck and armpits. This condition primarily affects the upper limbs and can cause various discomforts in the shoulders, neck, arms, and even hands. Thoracic outlet syndrome can be divided into three types based on symptoms: neurogenic, venous, and arterial. However, the neurogenic type is the most common, and patients often experience pain, weakness, numbness, and sometimes even atrophy of the muscles at the base of the thumb.
Symptoms of thoracic outlet syndrome may include pain, numbness in the shoulders and arms, and even changes in the color of the hands.
Thoracic outlet syndrome can occur for a variety of reasons and may be related to trauma, repetitive arm movements, tumors, pregnancy, or anatomical variations such as cervical ribs. For diagnosis, doctors may confirm it through nerve conduction tests and medical imaging, which is often not easy because the symptoms of many other diseases are similar.
The initial treatment for neurogenic thoracic outlet syndrome is usually exercises to strengthen the chest muscles and improve posture. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Naproxen can also be used to relieve pain. Surgery is often necessary in venous and arterial cases, especially if other treatments have failed.
Symptoms and signs
People with thoracic outlet syndrome most commonly experience pain in their shoulders, neck, arms, and hands, which may be intermittent or persistent. Pain can feel sharp, burning, or dull. This symptom may affect only one part of the hand (such as the little finger and the adjacent half of the ring finger), or the entire hand, inner forearm, and upper arm.
If not treated promptly, thoracic outlet syndrome can lead to neurological deficits, causing cognitive and motor difficulties.
In addition, color changes in the hands, a cold feeling on one side of the hand, and weakness and tingling in the hand and arm muscles are all common symptoms. It is important to note that only 1% of people with carpal tunnel syndrome also experience symptoms of thoracic outlet syndrome. Repetitive movements may cause muscle swelling, which may compress veins and cause blood clots.
Diagnosis process
Diagnosis of thoracic outlet syndrome is relatively difficult because there are no specific diagnostic criteria. Doctors often use medical imaging, nerve conduction testing, and a series of tests designed to induce symptoms to help confirm the diagnosis. For example, although Adson's sign and costoclavicular maneuver can be used for detection, they do not have sufficient specificity and sensitivity and should be used based on a detailed history and physical examination.
Treatment methods
Non-invasive physical therapy and stretching are usually the first choice for treatment of thoracic outlet syndrome. Through stretching exercises, you can relieve the pressure in the chest and reduce the pressure on blood vessels and nerves. For example, the movement might include leaning your shoulders forward and then back to a neutral position, then extending back. Physical therapy can further increase the range of motion and strength of the shoulder and arm, improving overall function.
The method of surgery depends on the severity of the disease. In some cases, it may be necessary to remove the first rib at the compression site.
In addition to physical therapy, surgery can be effective in reducing symptoms and improving quality of life in some cases where surgery is required. If you are experiencing ongoing pain and other related symptoms, it may be time to consult a medical professional for a more in-depth diagnosis and appropriate treatment.
After learning about thoracic outlet syndrome, do you have any other questions or things you still don’t understand?
