Thoracic outlet syndrome what kind of doctor

Neurogenic TOS affects the brachial plexus in the thoracic outlet. Causes and complications of thoracic outlet syndrome TOS can occur on either side of the body, but most often affects the side of your dominant hand because of constant use. Complications and symptoms vary depending on the type of TOS you have. Arterial thoracic outlet syndrome In arterial TOS, an artery in the thoracic outlet compresses, narrows, or dilates. Complications of arterial TOS can include: Arterial aneurysm — a bulging, weakened area in the artery.

Blood clots that form in the aneurysm. Embolization to the hand and fingers. This can block blood flow to the hand, causing: Pain Coolness Numbness Discoloration It's vital to restore blood flow to the hand quickly. Venous thoracic outlet syndrome In venous TOS, a vein in the thoracic outlet becomes compressed and damaged. Complications of venous TOS can include: Blood clots that form in the damaged vein.

Arm swelling. Pulmonary embolism. Neurogenic thoracic outlet syndrome In neurogenic TOS, the brachial plexus — the bundle of nerves in the thoracic outlet — compresses, usually because of: A prior injury.

Repetitive forces from exertional movements. Neck, arm, or shoulder weakness. Nerve damage. Thoracic outlet syndrome risks TOS happens to people of all ages and both genders. Factors that can increase your risk of TOS include: Stress from repetitive tasks. Playing a sport with repetitive arm motion — like baseball, volleyball, swimming, or tennis. Having poor thoracic posture.

Prior cervical spine or neck trauma. Arterial thoracic outlet syndrome symptoms Symptoms of arterial TOS include: Pain, coldness, and paleness or change of color in the hand. Cramping when using the arm. Venous thoracic outlet syndrome symptoms Symptoms of venous TOS include: Swelling and dark color in the arm. Arm pain. Any duplication or distribution of the information contained herein is strictly prohibited.

Access myPennMedicine For Patients and Visitors. Patient Information. Conditions Treated A-Z. Thoracic Outlet Syndrome.

Definition Thoracic outlet syndrome is a rare condition that involves: Pain in the neck and shoulder Numbness and tingling of the fingers A weak grip Swelling of the affected limb Coldness of the affected limb The thoracic outlet is the area between the ribcage and collarbone. Causes Nerves coming from the spine and major blood vessels of the body pass through a narrow space near your shoulder and collarbone on the way to the arms.

Pressure compression on these blood vessels or nerves can cause symptoms in the arms or hands. Pressure may happen if you have: An extra rib above the first one. An abnormal tight band connecting the spine to the ribs. People with this syndrome often have injured the area in the past or overused the shoulder. Symptoms Symptoms of thoracic outlet syndrome may include: Pain, numbness, and tingling in the pinky and ring fingers, and the inner forearm Pain and tingling in the neck and shoulders carrying something heavy may make the pain worse Signs of poor circulation in the hand or forearm a bluish color, cold hands, or a swollen arm Weakness of the muscles in the hand Exams and Tests Your health care provider will examine you and ask about your medical history and symptoms.

The following tests may be done to confirm the diagnosis: Electromyography EMG CT angiogram MRI Nerve conduction velocity study X-ray Tests are also done to rule out other problems, such as carpal tunnel syndrome or a damaged nerve due to problems in the neck.

Treatment Physical therapy is often used to treat thoracic outlet syndrome. It helps: Make your shoulder muscles stronger Improve your range of motion in the shoulder Promote better posture Your provider may prescribe pain medicine. During surgery, the following may be done: An extra rib is removed and certain muscles are cut. This procedure may be done at the same time as your procedure to have the first rib removed. If you're diagnosed with thoracic outlet syndrome, your doctor or physical therapist will instruct you to do exercises at home to strengthen and support the muscles surrounding your thoracic outlet.

In general, to avoid unnecessary stress on your shoulders and muscles surrounding the thoracic outlet:. Symptoms associated with thoracic outlet syndrome can be caused by a number of other conditions, which makes it difficult for doctors to diagnose the condition. Many people experience thoracic outlet syndrome symptoms for years before they are diagnosed with the condition, which can cause stress and frustration.

Be sure to discuss your concerns with your doctor if your symptoms persist and a diagnosis hasn't been made. You're likely to start by seeing your primary care doctor. In some cases, your doctor may refer you to a doctor trained in blood vessel vascular conditions or blood vessel surgery.

Preparing a list of questions will help you make the most of your time with your doctor. For thoracic outlet syndrome, some basic questions to ask your doctor include:. Your discomfort also may be improved if you maintain good posture and avoid using repetitive movements and lifting heavy objects.

Thoracic outlet syndrome care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version.

Diagnosis Diagnosing thoracic outlet syndrome can be difficult because the symptoms and their severity can vary greatly among people with the disorder. Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your thoracic outlet syndrome-related health concerns Start Here. Request an Appointment at Mayo Clinic.

Share on: Facebook Twitter. Show references Ferri FF. Thoracic outlet syndrome. In: Ferri's Clinical Advisor Philadelphia, Pa. Accessed July 19, Kuhn JE, et al.