Thoracic Outlet Syndrome

By Christina Lasich, MD, Health Pro Wednesday, October 07, 2009
Thoracic Outlet Syndrome (TOS) is nothing short of an elusive condition that baffles many doctors. Two types of TOS exist. One type is caused by an intermittent irritation to the nerves at the point of the thoracic outlet. The other type is caused by a disruption of the normal blood flow into the arm...
Anonymous
Anonymous
10/ 8/09 3:44pm

In 1999, in Los Angeles, I was diagnosed with Thoracic Outlet Syndrome.  We moved to South Carolina in 2005, and was still experiencing pain.  Went to an Orthopedic Specialist (terrific doctor) and he removed part of my collar bone...Consequently, no more pain in that area.  Unfortunately, it was only part of my pain history with Fibromyalgia...I am awaiting the day when true pain relief becomes a reality.  Yes, I am a middle aged woman. 

Anonymous
S. Lee
10/ 8/09 8:38pm

I am 43 yrs. old and was diagnosed with TOS 13 years ago.  There are many doctors that do not believe in TOS but I was referred to a vascular surgeon who specialized in TOS and, after thorough examination as well as a multitude of trial regimens, such as trigger point injections, my diagnosis of TOS was confirmed.  I even went to a specialist in Philadelphia who concurred with the diagnosis.  He told me that it is very rare to have a patient that truly has TOS but I definitely had it.  I underwent a 1st rib resection as well as a scalenectomy and my symptoms were relieved.  It is truly a shame when dealing with a doctor that doesn't believe in the syndrome.  I have encountered many, including my orthopaedist, whom I see for another problem.  I recommend that anyone whom suspects they have this syndrome should seek a doctor that specializes in TOS and do not give up if your doctor suggests that it is either not real or they cannot definitively diagnosis.  Keep seeking a doctor who will listen and believe in you.  I am not overweight and was diagnosed at a young age so I disagree with the article that states that this ailment affects middle-aged overweight women.  Good luck to all.

Anonymous
Chimaren
9/22/11 4:15pm

Yes, many doctors don't believe.  But, how fortunate surgery worked for you.  I have TOS and see a doctor in Denver, but I am curious to know who did your successful surgery.  Please e-mail me at sharonkellybland@verizon.net

Anonymous
Sharon
8/30/12 5:01pm

Please tell me who your doctor was in Philadelphia (the surgeon who did your surgery)?

Anonymous
Zeph
10/16/09 11:32am

Where is the article about the cheaters, that mess it up for us folks in real pain ?

Anonymous
Chimaren
9/22/11 4:14pm

Thoracic outlet syndrome comes in 3 varieties, two of which are congenital.  Further, it has nothing to do with the size of your arms or your age.  Further, it is a chronically degenerative condition that can kill you with aneurysms and embolisms, not just a neurological issue.  It affects your subclavian arteries, and will leave you severely disabled unless it is detected early and treated quickly (and you change jobs or activities)

8/30/12 1:55pm

 

Agreed! I couldn't believe this article! It's the second one I've read by her that was totally incorrect! She needs to be fired! I am ready to leave this site as I don't know if all of the info. provided here is incorrect to! This issue I know about as I have TOS. It's appaling to me how ignorant she is on the subject!

 

Middle aged women are not only demographic of people that develop TOS. It's very common in people who have jobs where their arms are always extended or up. For example:hair stylists, dental hygenists and assistants, people who use the computer all day, sheet rock installers are all prime candidates. Men and women! It destroys the lives of people of all ages. There is even a support group for children who develop it from breech delivery! I am involved in an international support group for TOS and MOST if not HALF of it's members are 30 and under.

 

There are many more symptoms that you've failed to include in this story. TOS doesn't affect just the arms and hands- it essentially can affect any part of your body from the chest  up- front and back. People with TOS suffer from migraines, TMJ pain, difficulty swallowing, Tinnitis, dizziness, fatigue, balance issues, chest, back shoulder, neck,and face pain, swelling of the arms and hands,and so much more!

 

Also, TOS is caused by several factors, but heavy weight in the arms isn't one of them! Poor posture, an extra cervical rib, fiborous bands, auto accident/whip lash are the main reasons.

 

Get your facts straight next time! Of course, I won't know whether or this occurs as I am leaving this site. I can't waste my valuable and limited online time (arms extened- get it??) researching for info. that could possibly help me on a site that provides information that is so blatantly WRONG!

 

 

 

 

8/30/12 1:55pm

 

Agreed! I couldn't believe this article! It's the second one I've read by her that was totally incorrect! She needs to be fired! I am ready to leave this site as I don't know if all of the info. provided here is incorrect to! This issue I know about as I have TOS. It's appaling to me how ignorant she is on the subject!

 

Middle aged women are not only demographic of people that develop TOS. It's very common in people who have jobs where their arms are always extended or up. For example:hair stylists, dental hygenists and assistants, people who use the computer all day, sheet rock installers are all prime candidates. Men and women! It destroys the lives of people of all ages. There is even a support group for children who develop it from breech delivery! I am involved in an international support group for TOS and MOST if not HALF of it's members are 30 and under.

 

There are many more symptoms that you've failed to include in this story. TOS doesn't affect just the arms and hands- it essentially can affect any part of your body from the chest  up- front and back. People with TOS suffer from migraines, TMJ pain, difficulty swallowing, Tinnitis, dizziness, fatigue, balance issues, chest, back shoulder, neck,and face pain, swelling of the arms and hands,and so much more!

 

Also, TOS is caused by several factors, but heavy weight in the arms isn't one of them! Poor posture, an extra cervical rib, fiborous bands, auto accident/whip lash are the main reasons.

 

Get your facts straight next time! Of course, I won't know whether or this occurs as I am leaving this site. I can't waste my valuable and limited online time (arms extened- get it??) researching for info. that could possibly help me on a site that provides information that is so blatantly WRONG!

 

 

 

 

Anonymous
Chimaren
8/30/12 4:58pm

Hey Mare!  Please provide contact information for the international support site for TOS patients !!!!! Need this.......

9/ 1/12 4:16pm

I see that my article about TOS has come under attack. Please note that I clearly stated that this article is meant to focus on Neurogenic Thoracic Outlet Syndrome, not the vascular type that has been mentioned in this line of commentary. 95% of those with TOS have the Neurogenic type. And yes, a risk factor is heavy loads and poor posture. Heavy loads do apply to heavy arms and poor posture is frequently associated with obesity. Additionally, like I said TOS is "more common in women" and "commonly found in the middle aged"; I didn't say that it is exclusively found in these particular cohorts.

 

Here's what the Clevland Clinic website has to say about TOS:

 

"Neurogenic TOS is the most common form of the disorder (95 percent of people with TOS have this form of the disorder) and generally affects middle-aged women.

 

Recent studies have shown that, in general, TOS is more common in women than men, particularly among those with poor muscular development, poor posture or both."

 

 

I guess that the Clevland Clinic and I are both "idiots" and are "blatantly WRONG". Or maybe some people don't like being told what they don't want to hear.

 

Dr. Christina Lasich, MD

6/ 6/12 1:14am

I too was diagnosed with Thoracic Outlet Syndrome back in 1984. At the time I was thirty-four years old and was a part-time phys.ed teacher. Fibromyalgia or as it was called back then, fibrositis had been diagnosed about four years prior.  I was in the hospital recovering from a discotomy L5-S1 and my family doctor arranged for a vascular surgeon to see me there. My complaint was of course loss of feeling in my hands and fingertips. When I lifted weights for example my hands would fall asleep and it became very dangerous. My shoulders at the time were not underdeveloped. But far worse than that was the tightness that was always present across my upper back. I used to say that I just wanted to remove my shoulders and shoulder blades for a few minutes to get some relief. I had surgery about a month and a half later for the left side and again another month and a half later for the right side. It was determined that I had an extra set of short, very fibrous ribs in the cervical area which had pierced the scalene muscle. The muscle was then sitting on the sub-brachial artery. This situation was found to be apparent on the opposite site as well.  There was some relief almost immediately in my hands however it took about a year before all of the tension in my upper back dissipated. At the time I was living in Northern Ontario and I was very glad that specialist had identified the situation in a relatively short amount of time.

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By Christina Lasich, MD, Health Pro— Last Modified: 03/21/13, First Published: 10/07/09