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Thoracic Outlet Syndrome (TOS)

What is Thoracic Outlet Syndrome?

Thoracic Outlet Syndrome (TOS) is a condition that occurs when blood vessels or nerves are under any type of compression. In some cases, both the nerves and the blood vessels can be compressed. This happens because they do not have enough space in the thoracic outlet located at the armpit and the base of the neck.

What does TOS do to the body?

TOS can cause the fingers to go numb, and many people suffering from this condition can feel pain in their neck and shoulders as well. A variety of conditions and events can cause TOS, as any enlargement or changes to the outlet or the tissues near the outlet can result in compression.

This includes conditions such as:

  • Receiving injuries to the neck or rib cage
  • Weight gain
  • Weight lifting
  • Tumors at the crest of the lung

Sometimes, doctors aren't actually able to determine the specific cause of TOS because its symptoms can vary greatly. They will typically involve numb hands and fingers because of the lack of circulation. They can also cause discoloration of the extremities, and even pain which results in weakness. Sometimes the symptoms will come and go and other times they will be persistent.

Diagnosing TOS in Injured Individuals 

To diagnose TOC, expert neurologists will look at the symptoms the patient complains of having, and may then try to replicate them by having the patient raise his or her arm above their ear. Certain motions can cause loss of a pulse, which the doctor will look for during the test.

The doctor might also want the patient to have an electromyogram, or EGM, which can help to detect the problem. Additionally, x-rays can often show the area where blood vessels might be constricted.

What treatments are available for TOS? 

It is possible to treat TOS with a number of different options, and most of them are relatively easy to implement. Doctors may have the patient perform exercises that help to stretch the thoracic outlet. This will relieve the compression on the nerves and blood vessels. It may also be suggested that patients try to avoid being in positions where their hands are above their heads or are stretched out in front of them for long periods of time. Those whose work or sport of choice puts them in these positions should be sure to take plenty of breaks to reduce fatigue.

Those who suffer from TOS because of their weight may want to consider a physician supervised weight-loss program. Some doctors might also prescribe anti-inflammatory medication to help with the symptoms. Most people will be able to have their TOS symptoms treated with very little trouble. However, in some cases, the patient may require surgery in order to relive the pressure on the blood vessels and nerves.

Get the Sports Neurology expert you need!

Looking for a Sports Neurology expert to serve as a witness for a TOS-related matter? With 20 years of experience as a board certified neurologist, I can be the expert witness you need on your side, both inside and outside of the courtroom. Ready to join forces? Request a case evaluation!

Contact me, Dr. Williams, at Vernon B. Williams, MD, Inc. today!

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