What is Thoracic Outlet Syndrome?
Thoracic Outlet Syndrome (T.O.S) is a condition where the nerves, arteries or veins are compressed between the collarbone and first rib, in the passageway from neck to the armpit.
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Compression of the nerves results in pain, weakness and loss of muscles at the base of the thumb.
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Compression of the veins results in swelling, pain and bluish colouration in the hands and arm.
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Compression of the arteries results in pain, coldness and paleness in the hands and arm.
CAUSES
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There are a few causes of T.O.S, some people will have more than one cause of the condition:
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1) Congenital Disorder (a birth defect) - this is the most common, especially for people who find themselves with an extra rib. Other abnormalities that cause T.O.S include muscular and fibrous connective tissue anomalies.
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2) Trauma (e.g. whiplash) or repetitive strain (this was the cause of my T.O.S, apparently swimming butterfly nearly everyday of your life and playing hockey aren't the best for your shoulders...)
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3) Rarer causes e.g. tumours
TREATMENT
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Physical: physiotherapy to strengthen chest muscles and improve posture. Stretching often using nerve glides and back strengthening for posture are key.
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Surgery: first rib resection is common, where the first rib id what is causing the compression; that section of the rib and any compressive fibres are removed, along with scalene muscles.