The primary symptoms of thoracic outlet syndrome are neck and shoulder pain, but many other injuries and diseases cause the same type of pain. While you may not need thoracic outlet syndrome treatments since the condition is rare, get the most accurate diagnosis from the best thoracic outlet syndrome doctors at Pain Management NYC. Call them with any pain that doesn’t get relieved with a couple days of rest. Make an appointment to find out definitively if you need thoracic outlet syndrome treatment and to prevent further complications.
What Is Thoracic Outlet Syndrome?
Thoracic outlet syndrome (TOS) is an umbrella term for diseases caused by compression of blood vessels or nerves in the region between your collarbone and first rib, called the thoracic outlet. Normally, your thoracic outlet is large enough to accommodate these nerves and blood vessels. TOS often results in shoulder pain, neck pain and numbness in your fingers.
Based on the structures affected, it’s classified into four types:l
- Neurogenic, caused by compression of the brachial plexus, affecting about one in 40,000 people each year
- Vascular, a rarer form of the nerve pain condition caused by compression of blood arteries, such as the subclavian artery or vein
- Venous, which is due to subclavian vein compression, affecting about one in every 50 cases of TOS
- Arterial, the most uncommon kind of TOS, accounting for less than one percent of all cases, caused by subclavian artery compression
While thoracic outlet neuropathies overall are rare, when it affects you, you need to find the best thoracic outlet syndrome doctors to get an accurate diagnosis and the most appropriate treatments. Pain Management NYC is a practice serving the New York and New Jersey areas that has several thoracic outlet syndrome doctors near me who have years of experience.
In addition to thoracic outlet syndrome treatment, they also treat conditions such as:
What Are the Symptoms of Thoracic Outlet Syndrome?
The symptoms of thoracic outlet syndrome depend on what category your condition falls into and which structures are involved.
Common symptoms include:
- Pain in your neck, shoulder and arm
- Numbness and tingling
- Color changes
- Cold sensations
- Impaired circulation in the affected arm
- Symptoms aggravated by arm elevation
- Difficulty with fine motor skills
TOS may result in a variety of adverse effects if left untreated, especially if the underlying reasons for compression persist.
Complications may include:
- Chronic pain. Untreated TOS can cause chronic pain in the neck, shoulder and arm.
- Muscle atrophy. Prolonged nerve or blood vessel compression in TOS leads to muscle weakening and atrophy.
- Nerve damage. Brachial plexus compression in neurogenic TOS may result in progressive nerve damage, potentially leading to sensory and motor impairments.
- Blood clots. Persistent compression in arterial and venous TOS can contribute to the formation of blood clots, raising the risk of deep vein thrombosis (DVT).
- Ischemia. Arterial TOS can cause a decrease in blood flow to the arm. If not addressed, this can result in an inadequate supply of blood.
- Functional impairment. Untreated TOS can drastically decrease the function of the afflicted arm over time, restricting mobility.
What Can Cause Thoracic Outlet Syndrome?
TOS is thought to be caused by several factors that result in nerve or blood vessel compression in the thoracic outlet, which is why it’s vital that you seek a diagnosis and testing from the best thoracic syndrome doctors.
Common causes include:
- Space reduced by structural flaws, such as an additional rib or an irregular first rib
- Over time, slouched shoulders that add to the compression
- Activities that require frequent arm and shoulder use
- Thoracic outlet structures that are injured because of accidents or falls
- Weakness or tightness in the muscles surrounding the outlet
- Heavy lifting and intense weightlifting that affect the shoulder and neck muscles
- Abnormal growths in the neck or chest
- Genetically prone to TOS
TOS is normally diagnosed using a combination of clinical and medical history evaluations and testing.
A general diagnostic procedure may include:
- A complete physical examination, including provoking movements when your doctor instructs you to take simple actions like raising your arms, tilting your head and clenching your fists
- X-rays to evaluate bone structures, MRI scans to evaluate soft tissue health, and CT angiography to examine the blood vessels
- Nerve conduction studies and electromyography (EMG) to assess nerve and muscle function
- Doppler ultrasound to check out blood flow, and angiography for more thorough vascular imaging
- Injections to confirm nerve compression
What Are the Available Thoracic Outlet Syndrome Treatments?
Thoracic outlet syndrome treatment aims to relieve symptoms and address the underlying reasons for compression. Options for thoracic outlet syndrome treatments are decided by the kind of TOS and the severity of your symptoms.
Once the cause and location of the compression is determined by thoracic outlet syndrome doctors, they may offer you treatment options, such as:
- Conservative management. Exercises to increase posture and muscle strength, as well as education on appropriate posture may be used in the beginning stages.
- Medications. NSAIDs or other pain relievers, as well as muscle relaxants, alleviate muscle tension.
- Lifestyle changes. Avoid exacerbating activities and adjust your workstations and everyday activities.
- Surgical intervention. For neurogenic TOS, first rib resection is performed to address brachial plexus compression, whereas venous and bypass surgeries address blood clot concerns in venous TOS and arterial reconstruction restores normal blood flow in arterial TOS.
- Injections of botulinum toxin. Botox is sometimes recommended for cases of neurogenic TOS.
- Anticoagulant treatment. This can be used for dorsal venous TOS if you have a clot history.
- Decompression of the thoracic outlet. These are operations used to release muscles, alter bone structures or solve anatomical abnormalities.
- Vascular procedure. For arterial TOS, angioplasty or stent implantation is recommended.
The success of TOS treatment is dependent on choosing the best thoracic outlet syndrome doctors. If any symptoms involving your nervous system appear, contact Pain Management NYC right away to begin the process of diagnosing your pain and beginning a path of healing that prevents further nerve damage.
Leon Reyfman, MD, is a top-rated, best-in-class interventional pain management doctor. He is a nationally recognized pain relief specialist and is among the top pain care doctors in New York City and the country. He is an award-winning expert and contributor to prominent media outlets.
Dr. Leon Reyfman has been recognized for his thoughtful, thorough, modern approach to treating chronic pain. He has been named a “top pain management doctor in New York” and one of “America’s Top Doctors™” for advanced sports injury treatments. Among other accolades, he was voted by peers as a “Castle Connolly Top Doctors™” and “New York Super Doctors™”. Dr. Leon Reyfman was a part of the medical team at the 2016 Summer Olympic Games in Rio de Janeiro, Brazil.