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What Is It

Compression of the nerves or blood vessels, or both, due to inadequate passageway between the base of the neck and the armpit (thoracic outlet)

Am I At Risk
Major risk factors include:

Anatomical Defects - an extra rib from birth (cervical rib) or an abnormally tight fibrous band connecting your spine and rib

Sex - more common in women

Poor posture - drooping your shoulders or holding your head in a forward position

Trauma

Repetitive activity of the upper body (computer typing, lifting objects above your head, swimming, etc.)

Obesity - can lead to excessive pressure on your joints

Pregnancy - due to loosening of joints during pregnancy

Symptoms

Pain, weakness, numbness, discoloration (paleness), or tingling in or around the neck, shoulder, arm or hand region

Symptoms can range from mild and occasional to severe and constant

How We Can Help

Consultation

In-depth physical examination, personal questioning, and analysis of your past medical history

Scalene Muscle Block

This test can assist you and our doctor in determining if you have thoracic outlet syndrome or not

Utilizing a small needle and local anesthetic, our doctor will electrically monitor and stimulate the muscles around your shoulder region in attempts to simulate your symptoms

It is normal to feel moderate discomfort or awkward sensations during and after the test; however, these feelings subside within hours

The test takes 15 minutes and is performed in our office

Somato-Sensory Evoked Potential Test

This test assists our doctors in ruling out neurological causes for your pain, specifically at the spine

Though our office does not perform this test, our doctors can refer you to one of many highly qualified neurologists

Treatment

Doctor's Orders
The doctor can offer personalized lifestyle changes and refer you for various noninvasive treatments. They include:

Physical Therapy - the treatment seeks to correct improper posture and strengthen muscles around the thoracic outlet region

Botox Injections - a single injection can relax and potentially relieve the muscle compression of the thoracic outlet for a month

Medication

Various anti-inflammatory, pain-relieving, and muscle relaxant drugs can assist in alleviating symptoms associated with thoracic outlet syndrome

Procedures

Surgical Decompression

Through a 2-3 inch incision in the shoulder or underneath the armpit, our doctors can remove a small section of your first rib, thereby alleviating the compression of your thoracic outlet compression

Local anesthesia and sedation are administered to minimize discomfort or pain during the procedure

The procedure typically requires 1 night of hospitalization

Following the procedure, there is very little, if not any, cosmetic defect from the missing rib section

The procedure is around 75% effective in alleviating symptoms

Our doctors will prescribe pain medication accordingly to minimize discomfort after the procedure

After 1 week, our doctors will reexamine you in our office for a follow-up consultation