How is thoracic outlet syndrome treated?

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.

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.

Howard E. Lewine, MD
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.
Lyall A. Gorenstein, MD
Thoracic Surgery (Cardiothoracic Vascular)
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.

Continue Learning about Brain and Nervous System

Brain and Nervous System

A healthy brain and nervous system regulate your body functions so you can have full command over your senses, muscles, and intelligence. Despite the amazing capacities of the human brain and nerves, they are vulnerable to damage ...

just like every other part of our bodies. Strokes, concussions, Alzheimers and many other brain problems affect about 50 million Americans. The multitude of brain injuries and illnesses strike different people based on the risk factors of their genetics, age and lifestyle. The severity of impairment and the availability of treatment vary widely. Knowledge of brain and nerve health has advanced rapidly in recent decades. Many new treatments and medicines are available to treat various disorders. Still, the best thing for your brain is to keep it physically and mentally active while eating nutritious food and getting plenty of social interaction.

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.