Narrowing of the thoracic outlet—the enclosed space between the base of the neck and the armpit through which nerves and blood vessels of the arm must pass—is called thoracic outlet syndrome (TOS).
Most often, thoracic outlet syndrome causes are either a congenital abnormality, including an extra rib, or muscle buildup causing a narrowing between the muscle and the first rib.
Thoracic outlet syndrome affects people of all ages and genders. The condition is common among athletes who participate in sports that require repetitive motions of the arm and shoulder, including baseball, swimming and volleyball.
Thoracic outlet syndrome treatment usually includes physical therapy, nonsteroidal anti-inflammatory drugs (NSAIDs) or short courses of steroids to eliminate symptoms like arm swelling, tingling or numbness in the fingers or radiating pain in the shoulder, arm or hand.
When these thoracic outlet syndrome treatment options are ineffective, surgery at our heart hospital in Dallas becomes a consideration. If the patient has an extra rib or a muscle buildup causing a narrowing between the muscle and the first rib, the physician can remove the first rib to redirect blood vessels around the area or remove part of it in a minimally invasive procedure known as a first rib resection. This surgical process creates more room for the blood vessels and nerves, and it lessens the pain and numbness caused by pressure, reducing the risk of aneurysms and blood clots in serious forms of thoracic outlet syndrome.
