Department of hand surgery & Microsurgery.

Thorasic outlet syndrome

What is thoracic outlet syndrome (TOS) ?

Nerves travel from the neck to our hands to provide movements and sensation. Along the nerves , blood vessels traverse which provide blood supply to hand. Compression of the nerves or blood vessels at the neck causes pain, aches , problems with sensation or weakness of hand. This is known as thoracic outlet syndrome.

What are the different types of TOS ?

As mentioned above , it can be vascular ( due to compression of blood vessels ) or neurogenic ( due to compression of nerves ).

Why is there compression of blood vessels or nerves ?

Blood vessels can be compressed due to structures which are anomalous or bigger than its normal size. For example, the presence of extra rib ( cervical rib ), band in the lung ( pleural band ) or hypertrophied muscles ( in muscular young adults ) can cause compression of blood vessels.

How common is TOS ?

It is rare . It is considered a “ diagnosis of exclusion “.

How is the condition diagnosed ?

TOS is suspected when the patient presents with suggestive symptoms. Diagnosis is confirmed with different investigations, depending on the type of TOS suspected. MRI, MRI angiography and Nerve conduction studies are few investigations of importance in TOS.

How is TOS managed ?

Patients with mild to moderate symptoms are managed successfully with activity modifications and exercises. Severe cases respond well to surgical management