Thoracic outlet syndrome is a collection of diseases affecting the thoracic outlet, specifically the nerves and blood vessels.
The thoracic outlet is the area between a person’s first rib and the collarbone. Thoracic outlet syndrome usually occurs because of compression of the nerves or blood vessels. This result to pain in the neck area and shoulders, numbness in the fingers may also occur.
Common causes of this disorder are pregnancy, body defects such as an extra rib, sports injuries, repetitive movements, weight gain, or trauma from a vehicular accident. Injuries in the past may also lead to this disorder in the present. In rare cases, the cause is tumor in the lungs or maybe unknown.
The treatment for this disease involves different methods such as pain relief measures and physical therapy. Most people with this disease get better through conservative approaches. However, in worst cases, surgery may be needed.
Types of Thoracic Outlet Syndrome
Symptoms of the disease may vary depending on the type of the thoracic outlet syndrome. Three types of the disease exist. One is the neurogenic type. This type involves compression of the network of nerves, known as the brachial plexus. The nerves come from the spinal cord. It aids in hand, arm, and shoulder sensation as well as muscle movements. The neurogenic type of this syndrome is the most common type.
Another type of the disease is the vascular type. This is happens when one or more of the veins and arteries located beneath the clavicle or collarbone are being compressed.
On the other hand, the non-specific type, this is also known as the common or disputed type. Some physicians say that this type is common, but some says that this type does not exist. Individuals with this type often experience chronic pain in the thoracic outlet area. The pain usually worsens with activity. The cause of pain is difficult or sometimes cannot be determined.
Symptoms of Thoracic Outlet Syndrome
The symptoms of thoracic outlet syndrome can differ depending on the structures involved. Signs and symptoms of the disease may include Gilliatt-Summer hand or the wasting in the thumb’s fleshy base. A tingling sensation or numbness may also be felt in the fingers because of nerve compression of the brachial plexus. Pain is common in the neck and shoulder area as well as in the hands and arms. Weakening of the grip may also be experienced.
Furthermore, because of the compression of the blood vessels such as the arteries and veins, the patient may also experience signs and symptoms of impaired circulation. These includes: discoloration of the extremities, pallor in the fingers or hand, and no or weak pulse in the affected extremity. A thrombus or blood clot may also form in the collarbone. In some cases, infarcts may occur, which causes the appearance of tiny black spots in the hands or fingers.
Causes of Thoracic Outlet Syndrome
Generally, thoracic outlet syndrome is a result of the compression of blood vessels and nerves beneath the collarbone, otherwise known as the thoracic outlet. The cause of compression may vary from one case to another. One cause of compression may be because of birth or anatomical defects. This includes being born with an unusually tight fibrous band used to connect the ribs to the spine, or an extra rib above the first rib.
Poor posture may also contribute to the occurrence of compression of the area in the thoracic outlet. People who often hold their heads forward or drop their shoulders frequently are more likely to develop this disease. Events that causes trauma, such as a vehicular accident may as well result to compression of the nerves. Nerve compression due to trauma often manifest delayed symptoms.
Repetitive activities often results on wearing down of body tissues. Activities that may result to the development of the disease include lifting objects above the head and typing on a computer. Swimmers and baseball pitchers are also at risk for this disease.
Other causes are pregnancy and joint pressure. Carrying heavy backpacks or bags as well as obesity can lead to high amount of stress on the joints in the thoracic outlet. The disease may also appear during pregnancy because of loosening of the joints.
Treatment of Thoracic Outlet Syndrome
In most cases, treatment may only involve a conservative approach. Treatment is also effect when the disease is diagnosed early. The use of relaxation techniques, medications, and physical therapy is common in treating the disease. Physical therapy helps the patient in improving posture and range of motion. It also strengthens the muscles in the thoracic outlet area, through exercises. Over time, this reduces pressure on the nerves and blood vessels in the area.
Relaxation techniques such as deep breathing exercises are also effective for thoracic outlet syndrome. It aids in maintaining proper posture and reduces tension on the shoulders. Anti-inflammatory medications and muscle relaxants may be used to relax the muscles and decrease inflammation.