TOS can be related to cerebrovascular arterial insufficiency when affecting the subclavian artery. Besides, overuse injury of the upper limbs causes swellings, small bleeding, and subsequent fibrosis which would cause the thrombosis of the subclavian vein, leading to Paget–Schroetter disease or effort-induced thrombosis. Repetitive motions can cause enlargement of muscles which causes compression of veins. Only 1% of people with carpal tunnel syndrome have concomitant TOS. Discoloration of the hands, one hand colder than the other hand, weakness of the hand and arm muscles, and tingling are commonly present. Pain can also be in the side of the neck, the pectoral area below the clavicle, the armpit/axillary area, and the upper back (i.e., the trapezius and rhomboid area). TOS can involve only part of the hand (as in the pinky and adjacent half of the ring finger), all of the hand, or the inner aspect of the forearm and upper arm. It can be sharp/stabbing, burning, or aching. Pain can be present on an intermittent or permanent basis. TOS affects mainly the upper limbs, with signs and symptoms manifesting in the shoulders, neck, arms and hands. The condition was first described in 1818 and the current term "thoracic outlet syndrome" first used in 1956. It is more common in women than men and it occurs most commonly between 20 and 50 years of age. The condition affects about 1% of the population. Blood thinners may be used to treat or prevent blood clots. Surgery is typically done for the arterial and venous types and for the neurogenic type if it does not improve with other treatments. NSAIDs such as naproxen may be used for pain. Initial treatment for the neurogenic type is with exercises to strengthen the chest muscles and improve posture. TOS is difficult to diagnose and there are many potential differential diagnoses as well as other diseases that are often co-occurrent with TOS. The diagnosis may be supported by nerve conduction studies and medical imaging. TOS may result from trauma, repetitive arm movements, tumors, pregnancy, or anatomical variations such as a cervical rib. The arterial type results in pain, coldness, and pallor of the arm. The venous type results in swelling, pain, and possibly a bluish coloration of the arm. The neurogenic type is the most common and presents with pain, weakness, paraesthesia, and occasionally loss of muscle at the base of the thumb. There are three main types: neurogenic, venous, and arterial. Thoracic outlet syndrome ( TOS) is a condition in which there is compression of the nerves, arteries, or veins in the superior thoracic aperture, the passageway from the lower neck to the armpit, also known as the thoracic outlet. Rotator cuff tear, cervical disc disorders, fibromyalgia, multiple sclerosis, complex regional pain syndrome, pectoralis minor syndrome Nerve conduction studies, medical imaging Trauma, repetitive arm movements, tumors, pregnancy, cervical rib Pain, weakness, loss of muscle at the base of the thumb, swelling, paleness, bluish coloration Ĭompression of the nerves, arteries, or veins in the superior thoracic aperture (thoracic outlet), the passageway from the lower neck to the armpit The right brachial plexus, viewed from in front. Medical condition Thoracic outlet syndrome
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