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Jason R. Schultz P.C

Thoracic Outlet Syndrome

What is TOS?

Thoracic Outlet Syndrome (TOS) is a group of disorders that affect the nerves in the brachial plexus (nerves that pass into the arms from the neck) and various nerves and blood vessels between the base of the neck and axilla (armpit).  A syndrome is defined as a group of signs and symptoms that collectively characterize or indicate a particular disease or abnormal condition.

Thoracic Outlet Syndrome involves compression, injury, or irritation to the neurovascular structures at the root of the neck or upper thoracic region. Trauma, such as a hyperextension/hyperflexion injury (rear end whiplash type injury) has been associated with the onset of TOS.

TOS gets its name from the space (the thoracic outlet) between your collarbone (clavicle) and your first rib. This narrow passageway is crowded with blood vessels, muscles, and nerves. If the shoulder muscles in your chest are not strong enough to hold the collarbone in place, it can slip down and forward, putting pressure on the nerves and blood vessels that lie under it.

TOS can result from injury, disease, or a congenital abnormality. Psychological changes are often seen in patients with thoracic outlet syndrome. It is not clear whether these precede the onset of the syndrome or are the result of dealing with the pain and frustration of diagnosing and treating this condition. Accident victims suffering from thoracic-outlet syndrome may undergo conservative treatment initially. This would include medications and physical therapy. If conservative treatment does not relieve the symptoms, a person may require surgical interventions.

A variety of other signs/symptoms that may be confused with TOS including carpal tunnel syndrome, cervical spine disease with nerve root compression, tumors of the spinal cord or brachial plexus, as well as a variety of other neuromuscular disorders.

Signs and Symptoms of TOS

Vascular symptoms include:

  1. Swelling or puffiness in the arm or hand;
  2. Bluish discoloration in the arm or hand;
  3. Feeling of heaviness in the arm or hand;
  4. Pulsating lump above the clavicle (collarbone)
  5. Deep, boring toothache-like pain in the neck and shoulder region, which seems to increase at night;
  6. Easily fatigued arms and hands; and
  7. Superficial vein distention in the hand.

Neurological Symptoms Include:

  1. Paresthesia along the inside forearm and the palm (C8, T1 dermatome);
  2. Muscle Weakness and atrophy of the gripping muscles and small muscles of the hand;
  3. Difficulty with fine motor tasks of the hand;
  4. Cramps of the muscles on the inner forearm
  5. Pain in the arm and hand; and
  6. Tingling and numbness in the neck, shoulder region, arm, and hand.

Treatment for individuals with TOS varies depending on the type. True neurologic TOS is generally effectively treated with surgery. Most other forms need only symptomatic treatment. Common or disputed TOS requires conservative treatment, which may include drugs such as analgesics and physical therapy to increase range of motion of the neck and shoulders, strengthen muscles, and induce better posture. Some cases of disputed TOS may require surgery (although, like the diagnosis, surgery is controversial). Heat, analgesics, and shoulder exercises have been used with limited success in individuals with traumatic TOS. Surgery may be needed in some cases. Vascular TOS often requires surgery.

If you are suffering from Thoracic Outlet Syndrome as the result of an injury and would like to work with a dedicated Atlanta Georgia Personal Injury Attorney who cares about your case, contact Jason R. Schultz PC. 

If you would like to work with an experienced and dedicated Georgia Thoracic Outlet attorney who is passionate about working on your case, please contact us for a consultation.  Jason R. Schultz PC is ready to provide the one on one attention you need and deserve.

For your free TOS consultation with a Georgia TOS Attorney, fill out our contact form or call us at (404) 474-0804.

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