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A small portion of the population is affected by a disorder that is often misunderstood. Thoracic Outlet Syndrome is actually a distinct group of disorders that affect the nerves that pass into the arms from the neck. They also affect various nerves and blood vessels between the base of the neck and the armpit. The disorders have little in common except for where they occur. They are complex, confusing and poorly defined. Various symptoms and signs occur in the upper limb. There are five different types of Thoracic Outlet Syndrome and each type has its own set of symptoms.
TRUE NEUROLOGIC TOS
True Neurologic TOS is the only type of Thoracic Outlet Syndrome that Scientists agree upon. This rare disorder is caused by congenital anomalies. It occurs predominately in middle-aged women and it almost always occurs on one side of the body. The symptoms of True Neurologic TOS include weakness and wasting of the hand muscles and numbness in the hand.
DISPUTED TOS
Disputed TOS is highly controversial. Some doctors don’t believe that it even exists, while other doctors feel that it is fairly common. This is why it obtained the name Disputed TOS. It is believed to be caused by a nerve injury in the brachial plexus. The symptoms of Disputed TOS include pain, weakness and fatigue.
ARTERIAL TOS
Arterial TOS is rare and is caused by a congenital anomaly. It occurs on one side of the body and affects both genders equally. It affects all ages, but occurs more in young people. The symptoms of Arterial TOS include sensitivity to cold in the hands and fingers, numbness and pain in fingers, finger sores and inadequate blood circulation.
VENOUS TOS
Venous TOS is listed as a “rare disease” by the Office of Rare Diseases of the National Institutes of Health. It affects less than 200,000 people in the United States Population. It affects both genders and develops suddenly often after unusual and prolonged limb exertion. The actual cause remains unknown. Venous TOS is also known as Paget-Schroetter Syndrome and it is sometimes called effert thrombosis. The symptoms of Venous TOS include pain and arm swelling.
TRAUMATIC TOS
Traumatic TOS is caused by a traumatic injury or repetitive activities. The symptoms include pain, tenderness; an abnormal prickling, burning sensation that is mostly felt in the hands, arms, legs or feet; sensory loss and weakness. Body postures will make these symptoms worse.
Overall, the symptoms of Thoracic Outlet Syndrome are numbness and tingling in the fingers; pain in the neck, shoulder and arm; headaches in the back of the head; weakness in the arm and coldness and color changes of the hand. Pain that occurs in the anterior chest wall, just below the collarbone and over the shoulder blade is often confused with symptoms of Thoracic Outlet Syndrome, but these symptoms are actually caused by a condition that frequently accompanies Thoracic Outlet Syndrome that is called Pectoralis Minor Syndrome. The symptoms of Thoracic Outlet Syndrome are often worse at night and during work and activities, especially when the arm is continuously being raised above the hand.
Thoracic Outlet Syndrome can be caused by tight muscles, ligaments, bands or bony abnormalities in the Thoracic Outlet which is just behind the collar bone. A nerve impingement is the problem 95% of the time, but occasionally an artery or vein is involved. It is most often produced by hyperextension neck injuries, auto accidents and repetitive stress in the work place. Occupations that are known to cause Thoracic Outlet Syndrome include work on an assembly line, keyboards or 10 key pads and filing or stocking shelves overhead. Thoracic Outlet Syndrome is caused by an extra rib, called a cervical rib in only 1% of the entire United States population. Sometimes no obvious caused can be found.
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