Is Thoracic Outlet Syndrome Serious?
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The honest answer is, it depends. The symptoms can be uncomfortable or even debilitating depending on the type and severity of your thoracic outlet syndrome, so let’s start by looking at what TOS is and the different forms it takes. To get in touch with a top neurosurgeon in Los Angeles, look no further than Dr. Yashar.

What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome (TOS) is identified as any one of a number of disorders that result in the compression of blood vessels or nerves located between your collarbone and first rib. This space is known as the thoracic outlet, giving the syndrome its name.

According to the Mayo Clinic, physical trauma is the most common cause of TOS. Mainly, it is associated with car accidents, repetitive injuries, or pregnancy. However, anatomical anomalies, such as having an extra rib, can also cause the compression associated with TOS.

Types of Thoracic Outlet Syndrome

TOS is actually a broad term used to identify several similar conditions. There are three primary types of TOS listed by Johns Hopkins Medicine.

1. Neurogenic Thoracic Outlet Syndrome

NTOS is the most common form and occurs when the nerves leading from the neck to the arm are compressed. NTOS makes up for more than 90% of all TOS cases. The symptoms of NTOS include:

  • Shoulder or arm pain and weakness
  • Tingling or discomfort in the affected fingers
  • Affected arm tires quickly, and in very rare cases…
  • Atrophy of the muscle in the palm, which leads to the thumb

2. Venous Thoracic Outlet Syndrome

VTOS is only responsible for about 5% of all cases, and it occurs when a vein is compressed in the thoracic outlet. Unfortunately, the nature of the condition can cause blood clots. The symptoms of VTOS include:

  • Swelling in the affected arm, hand, and fingers
  • A blue tinge to the skin on the affected arm and hand
  • Painful tingling in the affected arm and hand
  • Very prominent veins in the neck, shoulder, and arm

3. Arterial Thoracic Outlet Syndrome

ATOS is responsible for less than 1% of all cases, and it is identified by the compression of an artery in the thoracic outlet. The symptoms of ATOS include:

  • The affected hand is cold and pale
  • Pain in the hand and arm, particularly during any motion above the shoulder
  • Blockage of an artery in the affected hand or arm
  • Aneurysm of the subclavian artery

Dangers and Treatment

Overall, ninety percent of all TOS cases are relatively harmless though it can cause you pain and limit the use of your affected shoulder, arm, and hand. Therefore, in the case of Neurogenic Thoracic Outlet Syndrome, physical therapy is typically the first and only treatment. Your doctor will only consider surgery if all other options fail.

In contrast, both Venous TOS and Arterial TOS can have major consequences for your health, with ATOS presenting the most immediate danger. In most cases, surgery will be a necessary part of your treatment plan. However, these cases are extremely rare in comparison to NTOS, so if you are initially diagnosed with TOS, you probably have nothing to be seriously concerned about.

The key is to recognize possible symptoms and speak with your doctor as soon as possible. Dr. Yashar, a board-certified neurosurgeon, states that the following are tests your doctor may suggest.

  • Pulse Volume Recordings
  • X-rays of the neck and shoulder
  • Doppler Ultrasound
  • Nerve Conduction Velocity Test
  • MRI
  • Venography
  • Arteriography

Based on your initial examination and review of your medical history, one or more of these tests will help your doctor to definitively identify the form of TOS you may have, allowing them to put together a comprehensive treatment plan that could relieve your discomfort and potentially save your life.