Thoracic Outlet Syndrome Symptoms

The thoracic outlet syndrome is a spectrum of disorders involving compression at the superior thoracic outlet which affects the nerves of the brachial plexus. The brachial plexus anatomy is complicated and there are nerve roots, trunks, divisions and cords present. Due to compression of the nerves, or the compression of the subclavian artery and vein there are many symptoms which may be seen. These are known as thoracic outlet syndrome symptoms. These symptoms are mostly neurologic in nature and are more commonly seen in people who suffer from neck injuries in motor vehicle accidents and those who use computers for extended periods of time in faulty positions. This is also seen in overzealous athletes and musicians at times.

Symptoms of Thoracic Outlet Syndrome

• Swelling or puffiness in the arm may be seen if a blood vessel, that is, an artery or a vein is getting compressed.
• Cyanosis, that is, bluish discoloration of the arm may be seen. This occurs due to a decrease in the amount of oxygen reaching the arm.
• If a nerve is compressed, then the person may complain of a feeling of heaviness or numbness in the arm or hand.
• There may be a pulsating lump just above the clavicle if there is arterial pressure.
• There may be a deep seated pain in the neck and shoulder region. This pain may increase in intensity at night.
• The person may get easily fatigued, especially when using his arms.
• There may be superficial vein distension in the hand.
• There may be paresthesia along the inner side of the forearm and the palm.
• If there is nerve compression, then the person may complain of muscle weakness and eventually, there may be atrophy of the muscles that help to hold objects (long finger flexors) and the small muscles of the hand.
• The person may complain of difficulty with fine motor tasks of the hand.
• The person may complain of cramps on the inner forearm.
• Tingling and numbness in the neck, shoulder, arm, hands, etc.

Thoracic Outlet Syndrome Diagnosis

• One of the simple thoracic outlet syndrome tests is Adson's sign. This is one of the most common tests to reach a temporary diagnosis with the help of thoracic outlet syndrome symptoms. In this test, when the person turns his head to one side during deep inspiration, then there is loss of radial pulse in the arm. However, this alone cannot be used as a diagnostic test to check for thoracic outlet syndrome, as even people who do not suffer from thoracic outlet syndrome may be positive for this sign.
• The costoclavicular maneuver is another test that is said to help reach an initial diagnosis of thoracic outlet syndrome. In this test, the person is asked to stand in a relaxed posture, with the head looking forward then depressing and retracting the shoulders and extending the humerus and abducting it thirty degrees, while hyperextending the neck and the head. However, this test is also used to diagnose costoclavicular syndrome.
• Ask the patient to raise both his hands above his head. The affected arm will be paler than normal due to compromised blood supply to the arm.
• In a compression test, there will be pressure between the clavicle and the medial humeral head which causes radiation of pain or numbness in the affected arm.
• The above given tests alone are not sufficient to reach a diagnosis. It is best to do a arteriography if surgery is being planned to correct thoracic outlet syndrome due to pressure on an artery.

These were the various symptoms and the ways to diagnose this condition. The treatment for this condition will depend on the underlying anomaly, that is, compression of nerves or vessels, which are causing the above given symptoms.