The blood vessels and nerves that run to your arms are located right below your collar bone in an area called the thoracic outlet. When there is pressure against one of these blood vessels or nerves, it can cause problems in your arms and hands, and is known as thoracic outlet syndrome.
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Since The Ohio State University Wexner Medical Center is an academic medical center, our patients benefit from innovative research, a depth of medical expertise and the newest technologies and treatment techniques available.
Thoracic outlet syndrome is a relatively rare condition, and requires expert care. As a large referral hospital, Ohio State's vascular surgeons have extensive experience diagnosing and treating these conditions.
What Is Thoracic Outlet Syndrome?
Thoracic Outlet Syndrome (TOS) occurs when there is pressure against the blood vessels or nerves in your thoracic outlet area that causes you to experience symptoms in your arms and hands. There are three types of TOS:
- Neurogenic TOS – Caused by compression of the nerves to the arm. It makes up about 95 percent of all TOS cases. Symptoms include pain, numbness and weakness in your arm or hand.
- Venous TOS – Caused by obstruction of the main vein (subclavian vein) to the arm. It makes up about three to four percent of all TOS cases. Symptoms include swelling, dark discoloration of the arm, and neck pain. Patients with this type of TOS often are diagnosed with a Deep Vein Thrombosis in the arm.
- Arterial TOS – Caused by disease in the artery to the arm (subclavian artery). Arterial TOS is very rare, making up only one percent of all TOS cases. Symptoms include pain, discoloration, and coldness in the hand.
What Causes Thoracic Outlet Syndrome?
Thoracic Outlet Syndrome can be caused by a variety of factors. Each type of TOS has a different cause:
- Neurogenic TOS often has no specific cause but develops insidiously.
- Venous TOS may be caused by repetitive or strenuous use of the arm and shoulder.
- Arterial TOS is caused by a narrowing of the main artery to the arm.
Almost all arterial thoracic outlet syndrome cases occur as a secondary effect of having a congenital extra rib (cervical rib) or an abnormal first rib. The danger with arterial TOS is that it leads to blood clots that can block the circulation to your hand.