Thoracic outlet syndrome (TOS) is an umbrella term used to describe disorders caused by the compression, injury, or irritation of the nerves and blood vessels in the thoracic outlet, which is the area between your collarbone and your first rib. Dr. David L. Rollins, Dr. Vikram K. Rao, and the first-rate team at Northeast Ohio Vascular Associates (NEOVA) deliver treatment and surgery for TOS patients. From their state-of-the-art office in Willoughby, Ohio, they serve patients living in the Cleveland area.
Because TOS covers a variety of disorders that can affect a single area of your body, symptoms can vary greatly, depending on which structures (nerves, vessels, or both) are being compressed. The most common symptoms of TOS include:
If left untreated, thoracic outlet syndrome may lead to swelling, dysfunction, or loss of use of the affected extremity.
TOS has symptoms similar to many other conditions, including rotator cuff injury. TOS is caused by compression of the nerves, arteries or veins in the narrow passageway at the base of your neck into your arm. Common causes of such compression can include:
When the brachial plexus nerve roots are compressed it's called neurogenic TOS which is initially treated using physical therapy and surgery which could involve removing the scalene muscles in the neck, or removal of the first rib, or both.
TOS is more common in young adults, between 20 and 40 years of age, and tends to affect women more than men. The condition is usually addressed by using a combination of physical therapy with medical treatment and doesn’t usually cause any long-term effects. Anti-inflammatory medications can help decrease inflammation, while clot-dissolving medications can take care of any existing blood clots in the region, including subclavian vein blockages.
If physical therapy isn’t helpful, then decompression of the thoracic outlet by removing the first rib can be used to address the condition. Patients who have a blockage or clotting in the subclavian vein first require clot-busting drugs to remove the clot, followed by rib removal at a later date. Artery-related problems frequently require artery bypass as well as removal of the first rib.
At Northeast Ohio Vascular Associates, we accept most major insurance plans. Here is a short-list of just some of the most popular plans we accept. Please contact our office if you do not see your insurance provider listed here or if you have any questions.