![]() Jobs that require carrying heavy shoulder loads, lifting items overhead, or repetitive activities like typing on a computer or working on an assembly line.A surgery or accident that results in scar tissue around the brachial plexus and subclavian vessels.A car accident, fall, or other impact that causes a whiplash injury or damages the clavicle and shoulder area.Sometimes the cause is unknown, but common reasons are listed below. The thoracic outlet space can become reduced due to physical trauma, repetitive strain, or an anatomical defect. This is a relatively tight space where the nerves and vessels can become compressed. Sub-pectoralis minor space: The area between the rib cage and the pectoralis minor tendon and pec minor muscle.The brachial nerve plexus, subclavian vein, and subclavian artery pass through here. Costoclavicular space: The area between the clavicle and the first rib.Interscalene triangle : The area surrounded by the anterior scalene muscle anteriorly, middle scalene muscle posteriorly, and the first rib inferiorly where the brachial nerves pass through.Compression or an abnormality in any of these spaces- like a muscle abnormality or extra rib- can irritate the neurovascular bundle and blood vessels. There are three components of the thoracic outlet. Athletes are also at a higher risk of developing TOS, depending on the sport they participate in. This is most commonly diagnosed in adults between the ages of 20-50, and females are three times more likely to get it than males. Neurogenic TOS does not usually require surgery and can be managed, though it can become painfully disabling if not properly treated. Neurogenic TOS symptoms often develop gradually and are more pronounced with activity or when the arm is elevated. It is caused by compression of the brachial plexus, a network of nerves that comes from your spinal cord and controls muscle movement and sensation in your upper extremity. Neurogenic, also called neurologically, is the most common type of TOS, affecting around 95% of all people suffering from the condition. ![]() When venous and arterial thoracic outlet syndromes occur in tandem, it’s called vascular TOS. It can develop abruptly, often after intense arm exercise or activity, and only comprises about five percent of TOS cases. This can create blood clots that may be life-threatening if they break loose and make their way to the lungs. The compression of axillary and/or subclavian veins under the collarbone, the ones that carry blood away from the arm, is the cause of venous thoracic outlet syndrome. This type of TOS can happen abruptly and requires immediate medical attention. Surgical treatment is a common treatment option for this type of TOS. It can cause an aneurysm or blood clot that could be life-threatening. The reduction is often the result of a congenital abnormality- one present at birth- that reduces the size of the thoracic outlet.Īrterial is the least common type, affecting only 1% of TOS patients, but the most serious. Arterial TOSĪrterial thoracic outlet syndrome is caused by a compression of the axillary artery and/or subclavian artery, the main vessels that carry blood to the arm. Physical examinations, nerve conduction studies, and other additional tests can pinpoint the type, like a CT scan, X-ray, or MRI. Types of Thoracic Outlet Syndromeĭiagnosing TOS is not always easy and may require the intervention of a neurologist, vascular or thoracic specialist. Problems in this area can result in big-time pain and even life-threatening vascular issues if not treated promptly. When these sensitive fibers become compressed or irritated, it can result in a group of rare disorders called thoracic outlet syndrome. Several nerves and blood vessels run through this area on their way to service the arm and hand. It spans from the base of your neck to your shoulder joint in the upper chest. The thoracic outlet is a diamond-shaped space located behind the clavicle (collarbone) and on top of the first rib. ![]() 8 Ulnar Nerve Gliding Stretches What is Thoracic Outlet Syndrome? ![]()
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