Table Of Index
What is thoracic outlet syndrome?
Thoracic outlet syndrome is a condition when the nerves or vessels running from the upper body to the arm are compressed causing swelling, tingling, weakness, reduced blood flow, pain and numbness in the shoulder, arms, neck or hands. This is caused by trauma, exertion, repetitive movements, anatomic narrowing of muscles or some congenital conditions. When left untreated, pain might worsen with time. The wide range of symptoms can pose challenge and delay diagnosis. Moreover, conservative treatments such as pain medications and physical therapy help most people.
Types of thoracic outlet syndrome
Arterial thoracic outlet syndrome: This involves the compression of the subclavian artery. It is a rarest type of TOS. However, among individuals younger than 40, arterial TOS may be the most common cause of blood clots in the arm.
Neurogenic thoracic outlet syndrome: In this condition, the nerves are compressed. Neurogenic TOS occurs when there is pressure on the brachial plexus, which are the network of intertwined nerves traveling across the upper chest.
Venous thoracic outlet syndrome: This occurs when the subclavian vein is compressed. This condition is more common in men, particularly in their 20s or 30s.
Causes and Symptoms
Imaging tests: CT scan, MRI Scan or an X-ray can reveal an extra rib and other physical abnormality. An ultrasound will help detect blockages and narrowing of blood vessels.
Nerve tests: Results of these tests are generally normal in individuals with this condition, but they may rule out other causes.
Positioning tests: In this test, the doctor will move the arms and head in different directions to check if the symptoms appear. These tests may also cause some symptoms in healthy people.
Scalene muscle block: The doctor gives a shot that relaxes muscles to find out if it helps relieving the symptoms.
Blood circulation tests: An arteriogram and venogram can reveal blood clots and other damage to blood vessels.
Risk & Complications
Complications of thoracic outlet syndrome surgery include permanent damage to brachial plexus, complete or transient paralysis, subclavian artery injuries, severe sequelae, axillary artery thrombosis, weakness of the hand muscles, sensory deficit, and autonomic dysfunction.
Preparation of Treatment
There are various ways of preventing thoracic outlet syndrome. You should maintain a good posture.
Make sure to maintain a healthy weight. Take some breaks at work in order to stretch and move. It is important to create a work area which let you keep good posture and does not make symptoms worse. If you play a sport which involves repetitive arm motions, ask your coach or trainer about suitable exercises for strengthening the muscles around the shoulder. If a job requires heavy lifting and overhead arm movements, then talk to a doctor about exercises that may help decrease your risk of injury.
Best Hospitals for Thoracic Outlet Syndrome Treatment
Surgery: The doctor can advise surgery if conservative treatments are not responsive. Surgery may also be recommended if you experience worsening of symptoms. A surgeon who is trained in chest surgery typically does the procedure.
Physical therapy: In case a person has neurogenic thoracic outlet syndrome, physical therapy is the first line of treatment as it strengthens and stretches the shoulder muscles to fully open the thoracic outlet. This increases the range of motion and posture. The exercise may release the pressure from the blood vessels as well as nerves in the thoracic outlet.
Medicines: You might be suggested anti-inflammatory medicines, muscle relaxants or pain medicines. The medicines decrease swelling, relieve pain and promotes muscle relaxation. In case of a blood clot, you might need a blood-thinning medication.
Injections: Injections of a local anesthetic or a steroid medicine might be used to cure neurogenic thoracic outlet syndrome as they can help reduce pain.
Recovery after thoracic outlet syndrome surgery
The surgery generally takes nearly 90 minutes. Most patients would need to stay oveight in the hospital and leave for home the next moing. Recovery time could vary from one person to another. However, most patients may retu to normal activities the day after surgery. Retu to physical therapy or exercise generally starts 2-3 weeks later.
Award-winning CEO of Marlin Medical Assistance Pvt. Ltd
Dr. Mohammad Afzal Siddiqui is an award-winning CEO of Marlin Medical Assistance Pvt. Ltd., a professionally managed medical tourism holding company and the active Director of Alshifa Healthcare Services Pvt. Ltd., a full-service medical tourism aggregation agency servicing JCI and NABH/ NABL accredited Hospitals across the country’s 5 locations.
In addition to Marlin, Alshifa also includes Media Group, which houses Arabic Medical Tourism e-Magazine healthandtour.com. The E-magazine “مجلة الصحة والسياحة” provides a wide scope of medical tourism information to healthcare travellers to find a safe, effective and cost-saving solution for their medical and healthcare needs. In addition to running E-Magazine, Dr. Mohammad Afzal also serves as Delhi-state coordinator in Foundation of Healthcare and Wellness Promotion focused on bringing India’s Healthcare closer to the world and smoothen world’s access to Indian Healthcare.