Question

Brain and Nervous System

How is thoracic outlet syndrome treated?

A Answers (5)

  • Treatment for thoracic outlet syndrome (TOS) begins with exercise programs and physical therapy to strengthen chest muscles, restore normal posture, and relieve compression by increasing the space of the area the nerve passes through. Doctors will often prescribe non-steroidal anti-inflammatory drugs (such as naproxen or ibuprofen) for pain. If this does not relieve pain, a doctor may recommend thoracic outlet decompression surgery to release or remove the structures causing the compression of the nerve or artery.

    This answer is based on source information from the National Institute of Neurological Disorders and Stroke.

  • What treatment options are available for thoracic outlet syndrome?

    Treatment for neurogenic thoracic outlet can range anywhere from physical therapy to making sure that you're sitting at a desk in an ergonomically correct position. Learn more from Johns Hopkins Medicine about thoracic outlet syndrome.

  • AHoward LeWine, MD, Internal Medicine, answered
    First, you must be sure that your symptoms are definitely caused by thoracic outlet syndrome. This condition is rare.

    The "thoracic outlet" refers to an opening at the junction of the neck, upper chest and arms through which important blood vessels and nerves travel. If that region is narrow, there may be reduced circulation or a pinching of the nerves to the arm. When symptoms occur, it is called thoracic outlet syndrome.

    A person with thoracic outlet syndrome may have one or more of these symptoms in the arm and/or hand:
    • Pain
    • Tingling
    • Numbness
    • Weakness
    • Swelling
    Most often these symptoms are related to some cause other than thoracic outlet syndrome.

    I suggest that you first talk with your doctor. To start, diagnosing thoracic outlet syndrome requires a combination of the following:

    Pain, numbness, tingling, clumsiness and/or swelling in one arm without another explanation

    An abnormal finding during an examination that tests if you have an increase in pressure in the thoracic outlet. For example, when standing with your shoulders as far back and downward as possible, your doctor will check if the pulse at your wrist decreases or you have any numbness.

    If the diagnosis seems likely, I would next refer you to a neurologist. He or she will repeat the physical examination and likely order special testing of your nerve function

    Treatment options include simple measures to reduce pressure in the thoracic outlet. This can include improving posture; relaxing the muscles of the neck, thorax and shoulder; losing weight; or wearing a support bra. Physical therapy is usually helpful.

    Surgery to "open up" the thoracic outlet is needed in less than 10% of cases. It may be appropriate when the diagnosis has been well established, other causes of the symptoms have been ruled out and the more conservative therapies mentioned above have failed.
  • Doctors treat thoracic outlet syndrome with exercise and physical therapy to strengthen chest muscles, restore normal posture, and enlarge the area through which the blood vessels and nerves pass. Non-steroidal anti-inflammatory drugs can relieve pain. If the problem persists, vascular specialists may recommend surgery to release or remove the structures compressing the arteries and nerves.
  • ALyall Gorenstein, MD, Cardiothoracic Surgery, answered on behalf of Columbia University Department of Surgery
    The transaxillary approach for thoracic outlet syndrome is the preferred method of treatment for patients with severe symptoms related to the compression of the brachial plexus. The transaxillary approach combined with video assistance affords complete visualization of the thoracic outlet through a small incision, enabling decompression with less postoperative pain.
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How is neurogenic thoracic outlet syndrome treated?