Thoracic Outlet Syndrome

Question: How can Thoracic Outlet Syndrome be cured? It usually is worst when I wake up. I obviously sleep in a bad position and my neck, shoulders and sometimes my arm is locked in a bad position. Then my ring finger and pinky are numb when I wake up. Sometimes I have blotchiness in my hand.Vision is sometimes blurry. My pulse quickens under my arm pit. Once in a while my whole lower arm is numb. I have stiffness in the inside of my elbow. Then I move my neck around and get up it goes away. Sometimes when my neck gets real stiff I see stars to my right and left as I turn my head. There is a ringing in my ear that goes from slight to intense usually right after I wake up. Are these symptoms of Thoracic Outlet Syndrome and how can I help it? I workout 3 to 4 days a week for 30 minutes to an hour. I love to cycle and do spin classes but the strain on my neck is to much later. I am slightly overweight at 24% body fat.

Answer: Sounds a bit like it, have a doctor check your subclavian artery and vein. The cure is surgical decompression of aforementioned artery and vein.

Question: Thoracic outlet syndrome or cardiac problem? Chest pain has been relieved by beta blockers. Problem is solved, but which is the culprit? Cardiac because the beta blockers relieved the syptoms instantly? Or can beta blockers -block thoracic outlet syndrome/muscle pain too?

Answer: I have to agree.

Question: What kind of doctor would I see for Thoracic Outlet Syndrome? Please don't tell me a Thoracic Oulet Syndrome Doctor.. :o) Thanks!

Answer: I would suspect that a vascular specialist would be in order for this diagnosis .... such as a surgeon who specializes in vascular medicine ...

Question: Several questions about pain in neck and shoulders from car accident/thoracic outlet syndrome? In Jan. 2005, I was in a head-on collision deemed the fault of the other driver. They have $20,000 injury insurance and my medical bills to date total slightly more than that. I have until Jan. 21, 2007 to settle or file a lawsuit. I am still in pain after several months of physical therapy and one surgery for thoracic outlet syndrome. I've had all kinds of tests done, and the only thing anyone can come up with is TOS. The surgery fixed the tingling on the side I had done, but now my hand gets cold and my shoulder and neck hurt when I use them a lot or stand for any longer than 15-20 minutes. I don't want to do the other side because the side I had done has some adverse side effects. Is the pain ever going to go away? What's my next step? Do I talk to more doctors or do I accept that I may hurt forever? Is future pain worth anything in a lawsuit? Is it worth hiring a lawyer or should I try to negotiate a settlement myself? Anyone have good results with alternative medicine?

Answer: I HAVE LEARNED, NNNNNNNNEEEEEEEVER HAVE SURGEY, UNNNNNNNNTTTTTTTTIIL MY DYING BED!!! Doctors, ALL of them, DON'T make MONEY unless they CUT!! I was in a car accident back in '86 where my left shoulder was partially seperated, and I was bruised ALL the way down my left side!! I went to an Orthopedic Dr. then, and SHE said, honestly, "You weren't seperated that bad, and you just need excercises to get the soreness out, etc." TEN YEARS LATER. I was in a bar, watching the Olympics, I have to use the BATHROOM (bear with me, it brings me to what you need to know), and I'M BLEEDING like CRAZY! I run to the Emergency Room, and am STUCK in ICU for 3 DAYS and NIGHTS, UNABLE to get out of bed! When THAT was OVER, myCarpel Tunnel Syndrome, went CRAZY, i thought!! I wasn't just having pain in my left hand anymore, MY NECK, and SHOULDER were KILLING me, in PAIN! I went to a hand specialist, and he gave me a list of neck excercises to do, even thought he said,"You have Carpel Tunnel!" I didn't believe this guy, so I went to a Bone Dr., who said that I have Thoracic Outlet, TOO! I started doing those neck excercises, and MY NECK PAIN CLEARED UP!! (I still get pain in my left arm, and shoulder though some. But, I got a TENS unit, that you can get a prescription for, to improve THAT dramatically!)This ONE excercise in particular helped me. I lay down on the bed, or the floor, face up; bend my knees at about a 45 degree angle; lay them downn bent to one side at a 45 degree angle; look to the oher side; and put the arm to the side you are looking at aboutt a 45 degree angle. It STRETCHED my NECK after doing that to each side, for about a month, every day, and IT'S FINE now! But, do excercises, and get a TENS unit presciption from A bone dr. THEY HATE TO DO that BECAUSE they can't CUT you if you have ALLEVIATED pain!!! GET THE TENS unit!!

Question: Can thoracic outlet syndrome be covered under workmans comp? I have just been diagnosed with thoracic outlet syndrome after ruling out everything else. First I was told it was carpal tunnel. I have a job where I have terrible working conditions and do repetitive work every day. Lots and lots of data entry with no keyboard, mouse or back support. I have not been in an accident or injured and I've done clerical work all my life and never had this until I started this job a year ago. I see it can be work related but of course my boss is giving me an attitude about the whole thing. I'm missing work for appt's and not getting paid. I feel this should go under workman's comp. I can barely sit at work . I need helo..I'm losing my mind. I'm getting harrassment at work over this. Now what? any suggestions? Thanks

Answer: Your doctor would be the best one to answer this. It is probably work-related, but a statement from the doctor will be enough to show that it is work-related.

Question: Good questions to ask about Thoracic Outlet Syndrome? I have an appointment with my vascular surgeon in a few weeks and I would like to know what good questions are there to ask at this consultation?

Answer: Try a Yahoo search for "thoracic outlet syndrome".

Question: What is Thoracic Outlet Syndrome? What are the symptoms and what tests are done to diagnosis? Who can diagnosis this syndrome? I am asking this in regard to bilateral carpal tunnel syndrome.

Answer: 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

Question: Does ANYBODY have any info on Thoracic Outlet Syndrome? Specifically 1st rib resection? My friend has this, had his rib removed a year ago, and is now in constant pain. His local doctor here doesn't really have much experience with this, and his surgeon (out of state) pretty much told him that his case wasn't severe enough to do anything more (which boggles me, because if you're suffering, then it should be cause for concern) It's just frustrating, I can't seem to find any information that is helpful...

Answer: This is why chiropractors do everything possible to avoid surgery - it doesn't always work as advertised and can often make people much worse! And a chiropractor is about the only person who can help him at this point - they have caused a trapped nerve with their surgery! Get one off an insurance list near you, and they will give him a discount if he's not insured. It takes about 8-12 times to make a big difference but it WILL help.

Question: Thoracic Outlet Syndrome anyone? Hello:) A couple years ago I was diagnosed with Thoracic Outlet Syndrome or Thoracic Outlet Compression Syndrome, they did therapy and it got somewhat better. Doctor told me then he would not operate on me unless I lost weight...etc.... In the last couple years it has gotten much better I mean there is pain but its managable certainly easy enough to live with verses going under the knife. In the last 9 mos. I have lost 130 lbs. and when I go to sleep at night I wake up in the morning with my neck and shoulders hurting and now in the last couple days I have numbness in my fingers and hand on one side and pain in my wrist on the other side. Has anyone else experienced this and what did the doctor say about it? I don't have good insurance coverage so I haven't been to the doctor yet. I'm just curious if there are others out there in my similar situation....also the doctor said weight loss would help improve it but here I am in more pain now? How odd is that? Thanks!

Answer: I hate to confuse matters, but whether or not you had a thoracic outlet before, you've probably got carpal tunnel syndrome now! A lot of people who display symptoms of carpal tunnel syndrome first note that they wake up symptomatic. Sometimes the symptoms actually awaken them. Carpal tunnel syndrome is a median nerve compression that causes annoying and somewhat painful parasthesias in the distribution of the median nerve. This nerve basically supplies sensation to the thumb-ward half of the hand. The reason that it happens is that the nerve goes through a canal in the wrist along with some tendons and vessels. It can be aggravated by certain kinds of activities that use your hands a lot. When you sleep, the hands often curl up, flexing at the wrist. This can be enough to create impingement on the nerve. You wake up with nerve pain. Try tapping on your wrist right below the crease that separates the thumb side and pinkie side palm pads (between the thenar and hypothenar eminences). Does that elicit a bit of a zing in the same distribution as your symptom pattern? There are some techniques for managing carpal tunnel syndrome. If you agree that it might be happening to you, you'll probably do a bunch of googling and get some good ideas. Feel free to contact me if I can be of any further informational assistance.

Question: Thoracic Outlet Syndrome treatments(HELP)? I have thoracic outlet syndrome, it took the doctors 2 years to figure out what it was. I have tried physical therapy and massage therapy and going to the chiropractor everday. With no relief I have had to stop doing all the things that I loved so much before this problem came about...riding quads, jet skiing, hiking, swmming, and anything else that is fun. Now it is getting progrssively worse...my fingers are going numb and cold more often and the thought of getting out of bed in the morning sometimes makes me cry because of the pain. I have finally had it! I need to find a solution to my problem. I have been talking with my doctor about treatments. Neurolesion was one of them (shots in my back muscles) but I am affraid of needles... or surgery (to remove my extra rib on my right and left sides) I am terrified of that too. So I am wondering who out there has ever had any of these treaments and how they went. Anyone with any advice, PLEASE tell me!!

Answer: Sometimes, one's pathology outwieghs what can be fixed conservatively. If your TOS is being caused by an obstructive process such as the cervical rib, no amount of PT, chiropractic care, shots or medication will permanently relieve the situation since the obstruction still remains. If your cervical rib has been CONFIRMED to be the ACTUAL cause of your symptoms, surgery may be your best option, but be sure to get an orthopedist that specializes in this type of procedure. Preferrably, someone with a good reputation at a teaching hospital.

Question: Does anyone know about getting injections to help with thoracic outlet syndrome? I have been diagnosed with thoracic outlet syndrome and am in a great deal of pain. I can't take any more of it. The neurologist saw me today and wants to do an injection of lanacane Thursday but will this work? I can't find anything about it online. I need some advice.

Answer: Did he say where he was going to do the injection? Many times when injections are given it is a combination of an analgesic (numbing) and an anti-inflammatory such as steroids. An epidural injection is also an option which is more directed at the nerve. There are many causes of thoracic outlet syndrome so all of the possible causes need to be examined and then treated if appropriate. Have you been referred to a physical therapist? If not I would ask your doctor to do so. I have treated many cases of TOS and have also diagnosed many cases that were previously diagnosed by doctors as shoulder or neck pain.

Question: ADVICE on surgery for thoracic outlet syndrome? I would like to know if anyone has ever had surgery for TOS? If so, was it worth it? What were the proceedures? IF not, does anyone know what they do during surgery for a Vascular T.O.S? General info: I dont have an extra rib, its vascular which is affecting the subclavian artery. The Doctor suggested that Physical Therapy isnt an option. Should I get a second opinion?

Answer: Yes, if your TOS is vascular in nature, then your doctor is correct, physical therapy will not help (unless it is a musculoskeletal reson why the subclavian artery is have problems...such as tight muscles). What you describe sounds like there is some type of obstruction to the subclavian artery...if they is the case, I imagine that they may look into angioplasty or stenting. I've only had patients who've had the surgery for a cervical rib removal (usually because they need therapy for stretching afterwards)...but I imagine that if it is vascular in nature, this will not be the case and I'm surprise this isn't being done as an urgent surgery...but yes, I would get a second opinion from a vascular surgeon.

Question: Has anyone ever heard of the collar bone being displaced with thoracic outlet syndrome? I have been in pain for 10 years with my shoulder. Had several XRays and MRI's..Was told I have tendinits and possibly TOS. Going to see another Dr. soon. Just wondered if the collar bone moving is from the TOS or tendinits?

Answer: Yes, the two interact so what happens to one is going to happen pretty much to the other. Also the muscles are pulling the area really hard. I recommend you see a chiropractor because they specialize in conditions like this. I've enclosed a link where you can find a chiropractor in your area in the USA.

Question: Would anyone be interested in helping me start a national organization for thoracic outlet syndrome? I have a condition called thoracic outlet syndrome. I recently had surgery for it. This condition is not known well enough and needs to be talked about to Businesses and the population. I am a classic for this condition and have been through..well..you know what. It has been miserable and a life changing experience. I have been in chronic pain for over a year now and I can't even begin to speak on how it feels. I am holding strong but it's hard. I want to let others know how this happens... what causes it, how it's mostly caused by the work environment and how employers can prevent it. It's a very costly condition that could be prevented with minor expenses. I have done much research on it and know a lot about it and would like to start speaking on it. I really don't know how to start doing this. I'm looking for some help and funding so that I can start spreading the word, speaking to people and helping them before they become permanently disabled for life. Contact me!

Answer: I commend you for trying to share with others the pain and misery of your condition. If I may make some suggestions: you assume everyone knows what Thoracic Outlet Syndrome is. I seriously doubt that 5% of the population would know what you are talking about. And where I beg to differ is the cause. Some patients presenting your condition (also called braquial bundle syndrome) have a congenital bone malformation called a mega apophysis on C5 . Rarely the condition is caused by incorrect work positions. So you see you should start with an information campaign ( perhaps a specialized web page) ( you can borrow from wikipedia and some orthopedic sits for a good explanation) and a gathering of interested people. As for funding I was going to suggest Mr. Gates but the poor man is no longer the richest in the world and will have to save for his old age. Succes with your project.

Question: Does anyone suffer from thoracic outlet syndrome? My right shoulder and ribcage hurts all the time, I had liver and gall bladder tests done. Plus a chest xray. Everything came out fine. I am starting to wonder if it is a muscular or skeletal problem.

Answer: Thoracic outlet syndrome (TOS) refers to compression of the neurovascular structures at the superior aperture of the thorax. It represents a constellation of symptoms. The cause, diagnosis, and treatment are controversial. The brachial plexus (95%), subclavian vein (4%), and subclavian artery (1%) are affected. Most presentations to the emergency department (ED) are nonemergent and require only symptomatic treatment and referral. Neurologic symptoms: Pain, particularly in the medial aspect of the arm, forearm, and the ring and small digits Paresthesias, often nocturnal, awakening the patient with pain or numbness Loss of dexterity Cold intolerance Headache For more info: http://www.emedicine.com/emerg/topic578.…

Question: Please explain thoracic outlet syndrome due to cervical rib?

Answer: Cervical ribs extra ribs on the last cervical vertebral body. They can cause mass effect against the subclavian artery or vein or brachial plexus. This can lead to clots in the vessels and pain. TOS can also be caused by other congenital anomalies or trauma. True TOS can be fixed by surgery