Thoracic Outlet Syndrome Specialist

What is thoracic outlet syndrome?

Thoracic outlet syndrome is the name given to conditions caused by nerve and/or blood vessel compression in your neck and upper chest.

The three main types of TOS are:

Arterial thoracic outlet syndrome

This affects the subclavian artery, which supplies blood to your head and arms and passes under your collarbone.

Venous thoracic outlet syndrome

This condition affects the subclavian vein rather than the artery.

Neurogenic thoracic outlet syndrome

This condition affects the brachial plexus, a cluster of spinal nerves in your neck that spread out into your arms.

Most people who have thoracic outlet syndrome have neurogenic TOS.

What are the symptoms of TOS, and how is it diagnosed?

Symptoms of TOS include pain in your neck and shoulders along with numbness in your hand and arm. There are many possible causes for such symptoms, so it’s important to get a diagnosis from the experts at Rockland Thoracic & Vascular Associates.

After doing a physical exam and discussing your symptoms, your provider might order diagnostic tests. Imaging scans like an MRI show the area in greater detail.

Electromyography (EMG), which measures electrical activity in your muscles, and nerve conduction studies can test how well your nerves are working and how effectively messages are getting from your nerves to your muscles.

How is TOS treated?

The initial treatment of neurogenic TOS is physical therapy. This helps improve the range of motion in your shoulders and neck, strengthens your muscles, and improves your posture.

If physical therapy doesn’t help with your symptoms, you could require surgery. Neurogenic TOS requires first rib resection, to take the pressure off the brachial plexus. Venous and arterial TOS always require surgery to relieve pressure on the vein or artery, and sometimes reconstruction of the affected blood vessel.

There are two main approaches to TOS surgery:

1. The transaxillary approach is generally best for patients who have venous TOS. It’s usually used in patients severely affected by neurogenic TOS as well. The Rockland Thoracic & Vascular Associates team uses minimally invasive, video-assisted surgery (VATS) when they do this procedure to reduce pain and tissue damage.
2. The supraclavicular approach is best for patients who have arterial TOS. It can be more challenging to do this procedure for venous TOS but might be suitable for some patients who have neurogenic TOS.

To find out more about TOS surgery, call Rockland Thoracic & Vascular Associates today to schedule a consultation or book an appointment online.