Thoracic outlet syndrome

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Symptoms

By Mayo Clinic staff

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Illustration showing thoracic outlet 
Thoracic outlet

Generally, there are three types (subdivisions) of thoracic outlet syndrome.

  • Neurogenic (neurological) thoracic outlet syndrome. This form of thoracic outlet syndrome is characterized by compression of the brachial plexus. The brachial plexus is a network of nerves that come from your spinal cord and control muscle movements and sensation in your shoulder, arm and hand. In the majority of thoracic outlet syndrome cases, the symptoms are neurogenic.
  • Vascular thoracic outlet syndrome. This type of thoracic outlet syndrome occurs when one or more of the arteries and veins under the clavicle (subclavian vessels) are compressed.
  • Nonspecific-type thoracic outlet syndrome. This is also called disputed thoracic outlet syndrome or common thoracic outlet syndrome. Some doctors don't believe it exists, while others say it's a common disorder. People with nonspecific-type thoracic outlet syndrome have chronic pain in the area of the thoracic outlet, but the specific cause of the pain can't be determined.

Thoracic outlet syndrome symptoms can vary, depending on which structures are compressed. When nerves are compressed, signs and symptoms of neurologic thoracic outlet syndrome often include:

  • Numbness or tingling in your fingers
  • Pain in your shoulder and neck
  • Ache in your arm or hand
  • Weakening grip

Signs and symptoms of vascular thoracic outlet syndrome — compression of one or more of your veins and arteries — can include:

  • Discoloration of your hand (bluish color)
  • Subclavian vein thrombosis
  • Arm pain and swelling, possibly due to blood clots
  • Throbbing lump near your collarbone
  • Lack of color (pallor) in one or more of your fingers or your entire hand
  • Tiny black spots (infarcts) on your fingers

When to see a doctor
See your doctor if you consistently experience any of the signs and symptoms of thoracic outlet syndrome.

References
  1. Sheon RP. Overview of the nerve entrapment syndromes. http://www.uptodate.com/home/index.html. Accessed Sept. 9, 2008.
  2. NINDS thoracic outlet syndrome information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/thoracic/thoracic.htm. Accessed Sept. 9, 2008.
  3. Thoracic outlet syndrome. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00336. Accessed Sept. 9, 2008.
  4. Thoracic outlet syndrome general information. National Pain Association. http://www.nationalpainfoundation.org/MyPain/contentdirectory_ThoracicOutletSyndrome.asp. Accessed Sept. 9, 2008.
  5. Thoracic outlet syndromes. Merck Manuals Online Medical Library. http://www.merck.com/mmhe/sec06/ch095/ch095e.html. Accessed Sept. 9, 2008.
  6. Thoracic outlet syndrome. Society for Vascular Surgery. http://www.vascularweb.org/patients/NorthPoint/Thoracic_Outlet_Syndrome.html. Accessed Sept. 9, 2008.

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Nov. 8, 2008

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