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.
Compression of the nerves results in pain, weakness and loss of muscles at the base of the thumb.
Compression of the veins results in swelling, pain and bluish colouration in the hands and arm.
Compression of the arteries results in pain, coldness and paleness in the hands and arm.
CAUSES
There are a few causes of T.O.S, some people will have more than one cause of the condition:
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.
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...)
3) Rarer causes e.g. tumours
TREATMENT
Physical: physiotherapy to strengthen chest muscles and improve posture. Stretching often using nerve glides and back strengthening for posture are key.
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.