<H1 class=documentFirstHeading> Thoracic Outlet Syndrome More than just a pain in the neck. </H1>

Thoracic outlet syndrome is actually a collection of syndromes brought about by abnormal compression of the neurovascular bundle by bony, ligamentous or muscular obstacles between the cervical spine and the lower border of the axilla. <H2>What does that mean?

First of all a syndrome is defined as a group of signs and symptoms that collectively characterize or indicate a particular disease or abnormal condition.

• The neurovascular bundle which can suffer compression consists of the brachial plexus plus the C8 and Tl nerve roots and the subclavian artery and vein.
• The brachial plexus is the network of motor and sensory nerves which innervate the arm, the hand, and the region of the shoulder girdle.
• The vascular component of the bundle, the subclavian artery and vein transport blood to and from the arm, the hand, the shoulder girdle and the regions of the neck and head.

The bony, ligamentous, and muscular obstacles all define the cervicoaxillary canal or the thoracic outlet and its course from the base of the neck to the axilla or arm pit. Look at the scheme of this region and it all becomes more easily understood.


</H2>What are the signs and symptoms of thoracic outlet syndrome?

It is important to understand that presenting with the symptoms listed below in no way indicates a definitive diagnosis for thoracic outlet syndrome. Professionals understand the importance of coupling diagnostic testing skills with the patient’s report of what hurts and what doesn’t seem to be working properly. Don’t self diagnose! Neurologic and vascular symptoms can be indicative of more serious conditions. Vascular symptoms include:Neurologic symptoms include:

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

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