Symptoms
By Mayo Clinic staffGenerally, there are three types 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 collarbone (clavicle) 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 that worsens with activity, 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 neurological thoracic outlet syndrome often include:
- Wasting in the fleshy base of your thumb (Gilliatt-Sumner hand)
- 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)
- Blood clot under your collarbone (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
- Weak or no pulse in the affected arm
- Tiny, usually 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.
- Sheon RP. Overview of the nerve entrapment syndromes. http://www.uptodate.com/home/index.html. Accessed Sept. 7, 2010.
- NINDS thoracic outlet syndrome information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/thoracic/thoracic.htm. Accessed Sept. 4, 2010.
- Thoracic outlet syndrome. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00336. Accessed Sept. 4, 2010.
- Thoracic outlet syndrome. National Pain Foundation. http://www.nationalpainfoundation.org/articles/577/what-is-it? Accessed Sept. 4, 2010.
- Thoracic outlet compression syndromes. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec16/ch223/ch223k.html?qt=thoracic%20outlet%20syndrome&alt=sh. Accessed Sept. 4, 2010.
- Thoracic outlet syndrome. Society for Vascular Surgery. http://www.vascularweb.org/vascularhealth/Pages/ThoracicOutletSyndrome.aspx. Accessed Sept. 4, 2010.

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