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Thoracic Outlet syndrome

Thoracic outlet syndrome (TOS) causes pain, numbness cold, and sometimes changes in colour to an arm.

The thoracic outlet is the space in the structure of the shoulder that allows veins, arteries and nerves to enter the arm. If the space becomes compressed due to injury the structures that run through the thoracic outlet may be affected as well. The most common form of TOS is neurogenic TOS. Numbness and tingling is common, usually but not always in the 4th and 5th fingers.

If the compression on the thoracic outlet is constant the condition may be relatively easy to diagnose through nerve conduction studies. More commonly, the compression is only intermittent. This makes it much harder to diagnose because if the condition is not active when the testing is done everything will appear normal.

Most people who develop TOS have a pre-existing anatomical abnormality that made them vulnerable to the condition. However, absent trauma from something like a car accident in most cases the TOS would never have developed. Trauma causes muscles around the thoracic outlet to go into spasm and compress the available space.

TOS symptoms can be similar to problems created by an injury to the spine in the neck so it is important to have your doctor assess you.

TOS comes in varying degrees of severity. Severe cases of TOS cause atrophy of the affected arm and usually necessitate surgery. Mild forms of TOS may be little more than an inconvenience. TOS is usually aggravated by activities involving raising the arm overhead, or repetitive motion activities like typing. Temporary or even permanent modification of these activities may be necessary.

Before considering surgery, there are a number of less radical treatments that are normally proposed including physiotherapy, and even Botox injections. If you are diagnosed with TOS, we will ensure that you are given the treatment needed to maximize your recovery. Severe TOS can affect your ability to work and take care of your home. We will ensure that the appropriate experts address any problems created by your injury.