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Thoracic Outlet Syndrome

The thoracic outlet is a narrow passage or space between the first rib and the collar bone (clavicle). Enlargement of the tissues and muscles of thoracic outlet can lead to Thoracic Outlet Syndrome.

What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome is a complex condition in which blood vessels and/or nerves are entrapped or compressed as they exit the thorax. There are three types of Thoracic Outlet Syndrome:

  • Neurogenic: Affects nerves leading from the spinal cord to the neck to the arm. Most thoracic outlet syndrome cases involve nerves.
  • Venous: Affects veins
  • Arterial: Affects arteries

Most cases of Thoracic Outlet Syndrome are neurogenic. 

Thoracic Outlet Syndrome

Signs and Symptoms of Thoracic Outlet Syndrome

The symptomatology of Thoracic Outlet Syndrome is the result of compression of vital vessels and/ or nerves of the upper thoracic area. Thoracic Outlet Syndrome presents with:

  • a feeling of numbness
  • muscle weakness
  • moderate to severe pain in the neck or shoulder region

Causes of Thoracic Outlet Syndrome

Most frequently reported causes are:

  • Congenital or acquired deficits that may lead to the overcrowding of thoracic outlet (such as presence of a cervical/ accessory rib or formation of fibrous band in the region)
  • Chronic abnormal posture (forward tilting head or droopy shoulders)
  • History of trauma/ assault or injury to the upper chest area
  • Chronic repetitive motion (such as sports or athletic activities or certain occupations that requires aggressive weight lifting)
  • Chest tumor
  • Obesity
  • Ribs extension

Statistics and Epidemiology related to Thoracic Outlet Syndrome

It is estimated that the incidence of Thoracic Outlet Syndrome is 3 to 80 cases per 1000 of the general population.

Reference: 
  1. Huang, J. H., & Zager, E. L. (2004). Thoracic outlet syndrome. Neurosurgery, 55(4), 897-903.
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