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What Is Thoracic Outlet Syndrome? (Part 1 of 2)

Posted Jan 22 2009 5:32pm

The thoracic outlet is the region connecting your chest and neck to your shoulder, where bundles of nerves and arteries pass through to supply sensation or blood to your arms. If they get compressed for a few minutes at a time, it won’t affect the blood flow or nerve sensation significantly–but if you spend too many hours and days hunched over, you could develop aches and pains that migrate throughout your arms and are hard to pinpoint or diagnose. That’s Thoracic Outlet Syndrome.

When you hunch over, the muscles that surround the thoracic outlet can pinch and compress those bundles of nerves, arteries and veins. When bloodflow is reduced, the arms don’t get the oxygen or nutrients they need, and they have a hard time getting the old blood and lymph back through to your heart. The backup causes muscles to get starved for nutrients, getting swollen and sore, and making them more susceptible to injury. Pinched nerves can also cause pain, tingling and stiffness throughout the arms and hands.  If the compression lasts too long, it can cause lasting damage.

Whiplash caused by a car accident is one cause of this disorder. The other main cause is poor posture and ergonomics. Those who spend too many hours and days hunched over a computer workstation can get accustomed to this incorrect posture, making it a chronic condition.

If you want to get technical and take a close look at your anatomy, there are actually different types of thoracic outlet syndrome, depending what region and parts are affected. The nerves pass primarily through the neck and the upper shoulder, while the arteries come in through the chest muscles to the arms. Wikipedia has a visual diagram showing some of these pathways and an anatomical description–a little technically heavy but useful too.

What patients should know is that Thoracic Outlet Syndrome can be tough for a doctor or physical therapist to diagnose.  Certain tests that have been developed aren’t always reliable.  The condition can cause pains throughout the arm, making it hard to pinpoint. Additionally, the reduced bloodflow and pinched nerves can cause secondary injuries like tendinitis (swollen tendons), epicondylitis (tennis elbow) or other problems, which may even need separate treatment.

In the next posts, we’ll look at how to identify Thoracic Outlet Syndrome, as well as some ways you can treat yourself or find the correct treatment.

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  1. Recognizing and Treating Thoracic Outlet Syndrome (Part 2 of 2)
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