Thoracic Outlet Syndrome, Physiology and Causes – Part 1/3

What is Thoracic Outlet Syndrome?


In order to know what Thoracic Outlet Syndrome is, or TOS, it’s best to know what and where you can find the Thoracic Outlet. The space between the collarbone and the first rib is known as the Thoracic Outlet.

The TOS involves a group of disorders that involves the thoracic outlet whether as caused by an injury, compression or irritation of the blood vessels, nerves and veins. The patient may experience neck pain and/or shoulder pain that reaches the arms and even causes finger numbness.

What Are the Causes of  TOS?

The causes for Thoracic Outlet Syndrome vary greatly but generally, it is caused by compression of the blood vessels and nerves in the thoracic outlet. This compression can be caused by any of the following: trauma, congenital defects, poor posture, activity, joint pressure or even pregnancy.

You can have a congenital defect that may cause you to suffer from this condition. If you have an extra rib just above your first rib (cervical rib), or if you have an abnormal fibrous band that connects the spine to your rib, then you are more likely to have TOS.

If you suffer from an accident that causes compression to your thoracic outlet and you experience pain in that area, then you may be suffering from TOS. The onset of the symptoms doesn’t occur after the trauma though as it is usually delayed.

Poor posture can compress the thoracic outlet. Drooped shoulders as well as constantly keeping a forward head position could cause TOS. Repetitive activity is also another cause as the body’s tissue can wear out over time as you do the same activity over and over again. The types of repetitive activities vary from typing to swimming.

Being overweight causes different types of problems. When you are overweight or obese, you tend to put more pressure on your joints that can also cause Thoracic Outlet Syndrome. It’s like carrying around a huge backpack wherever you go.

Pregnancy, just like with obesity, can also cause thoracic outlet syndrome. But with pregnancy, the woman’s body changes and one of these changes happen in the joints. The joints tend to loosen up during pregnancy and women become more prone to suffering from TOS.

What are the Symptoms to Watch out for?

The symptoms of the Thoracic Outlet Syndrome vary as it depends on which of the structures are suffering from compression. The nerves, veins or arteries can get compressed and symptoms such as shoulder or neck pain, pain on the hands and arms, numbness of fingers, vein thrombosis, swelling and arm pain, collarbone throbbing, and discoloration of the hand are just some of the symptoms associated with Thoracic Outlet Syndrome.

How is it detected?

The Thoracic Outlet Syndrome is difficult to diagnose as the severity and symptoms vary greatly. Doctors would suggest the patient to take medical tests to see if they are indeed suffering from TOS. Such tests include Adson’s maneuver, Wright test and Roos stress test.

If you have any additional information about TOS please feel free to ad it in a comment section.



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