Thoracic Outlet Syndrome (TOS)

What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome (TOS) refers to a condition that affects the area between the rib cage and the collar bone. In that area, blood vessels and nerve pass through a narrow space leading to the arm. If they do not have sufficient room and are compressed symptoms materialize in the hands or arms.

The presence of an extra rib above the typical first rib can cause the condition or it can be attributed to an abnormally tight band connecting the spinal vertebrae to a rib. An old injury in the area or overuse of the shoulder can also cause thoracic outlet syndrome, which is more prevalent in people whose necks are long and whose posture is characterized by slouched or “droopy” shoulders.

Thoracic Outlet Syndrome Symptoms

The symptoms of thoracic outlet syndrome include pain, numbness, and a sensation of tingling in the outside fingers of the hand (the “pinkie” and “ring” fingers) as well as the inner forearm. These same sensations can be present in the neck and shoulders and can be more evident when the patient is carrying a heavy object. Other signs of poor circulation in the hand or forearm include a blue tint to the skin, hands that are perpetually cold, or swelling. Weakness of the muscles in the hand may also be present.

Diagnosis and Treatment of Thoracic Outlet Syndrome

In order to diagnose thoracic outlet syndrome, physicians may order an electromyography (EMG), an MRI, a nerve conduction study, and x-rays. Additional tests may be used to exclude conditions like carpal tunnel syndrome.

When a diagnosis is confirmed, physical therapy will help to strengthen the muscles in the shoulder and to improve the overall range of motion. A secondary goal is improvement of the patient’s posture. Certain injections and modification of work activity may help. If the patient’s symptoms do not improve, surgery may be necessary.

At Neurological Associates of West Los Angeles our neurologists specialize in the treatment and diagnosis of thoracic outlet syndrome (TOS).   Dr. Jordan, Dr. O’Connor and Dr. Chang treat and diagnosis patients with thoracic outlet syndrome.  If you have TOS or your doctor suspects you have TOS and need a specialist contact our neurologists to schedule an appointment 310-829-5968.

Research Publications

Our neurologists take great pride in the often innovative research they do which helps increase the clinical understanding of Thoracic Outlet Syndrome (TOS), determining the effectiveness of new therapies and educate the medical community.  To find a list of research publications our neurologists have published on Thoracic Outlet Syndrome.