Written June 7, 2024Encino Vascular Institute

Thoracic Outlet Syndrome (TOS) is a complex condition that can cause various symptoms, affecting the nerves and blood vessels between the collarbone and the first rib. Recognizing these symptoms and seeking appropriate treatment in California can significantly improve your quality of life. In this comprehensive guide, we will explore the symptoms, causes, and treatment options for TOS and provide information on the specialists and experts in California who can help you manage this condition.

What is Thoracic Outlet Syndrome (TOS)?

Thoracic Outlet Syndrome occurs when blood vessels or nerves in the space between the collarbone and the first rib (thoracic outlet) are compressed. This can lead to pain in the shoulders and neck and numb fingers. Understanding thoracic outlet syndrome helps recognize the early signs and seek timely treatment.

Thoracic Outlet Syndrome (TOS)  in California.

What are the most common causes of Thoracic Outlet Syndrome?

There are several common causes of Thoracic Outlet Syndrome:

  1. Anatomical Defects: Some people are born with extra ribs (cervical ribs) or an abnormal tightness of the fibrous bands connecting the spine to the ribs.
  2. Poor posture: Slouching or dropping your shoulders can cause compression in the thoracic outlet.
  3. Trauma: Accidents or injuries, particularly to the neck or shoulder, can cause TOS.
  4. Repetitive Activity: Repetitive movements, especially overhead motions like lifting, can lead to TOS.
  5. Weightlifting: Excessive weightlifting can lead to muscle enlargement that compresses the thoracic outlet.
  6. Tumors: Rarely, tumors can compress the thoracic outlet.

Thoracic Outlet Syndrome Symptoms

Recognizing the symptoms of thoracic outlet syndrome is crucial for early diagnosis and treatment. The symptoms can vary depending on which structures are compressed – nerves, veins, or arteries. Here are the common thoracic outlet syndrome symptoms categorized by the type of TOS:

Neurogenic Thoracic Outlet Syndrome

Neurogenic TOS is the most common thoracic outlet syndrome type involving brachial plexus compression (nerves coming from the spinal cord to the arm).

  • Numbness or tingling in the fingers
  • Pain or aching in the neck, shoulder, or hand
  • Weakening grip and difficulty with delicate motor tasks
  • Atrophy of the hand muscles

Venous Thoracic Outlet Syndrome

This type of symptom involves compression of the veins, leading to:

  • Swelling in the arm or hand
  • Bluish discoloration of the skin
  • The feeling of heaviness in the arm
  • Blood clots in the veins of the upper body

Arterial Thoracic Outlet Syndrome

This rare type of symptom involves compression of the arteries, causing:

  • Cold sensitivity in the fingers and hand
  • The pale or blue color of the skin on the hand
  • Weak or absent pulse in the arm
  • Small black spots on the fingers (signs of tissue death)
Arterial Thoracic Outlet Syndrome : specialist for Thoracic Outlet

What Does Thoracic Outlet Syndrome Feel Like?

Many patients ask, “What does thoracic outlet syndrome feel like?” The sensations can range from mild discomfort to severe pain and disability. Common descriptions include a persistent ache, shooting pains, or a feeling of heaviness and fatigue in the affected limb. Some people also experience a pins-and-needles sensation or a burning feeling in their hands and fingers.

Seeking Treatment for Thoracic Outlet Syndrome in California

If you suspect you have TOS, seeking prompt medical attention is essential. Many thoracic outlet syndrome specialists in California can help diagnose and treat this condition. Here’s what you need to know about thoracic outlet syndrome treatment:


Diagnosing TOS involves a combination of physical examinations, medical history, and diagnostic tests. Tests may include:

  • X-rays: To check for extra ribs or other bone abnormalities.
  • MRI: To visualize the soft tissues and identify compressions.
  • CT Angiography: To examine the blood vessels.
  • Electromyography (EMG): To evaluate the electrical activity of muscles.

Non-Surgical Treatments

For many patients, non-surgical treatments can alleviate symptoms. These include:

  • Physical Therapy: Focused exercises to strengthen the shoulder muscles and improve posture.
  • Pain Management: Medications and injections to manage pain and inflammation.
  • Lifestyle Modifications: Adjusting activities and ergonomics to reduce stress on the thoracic outlet.

Surgical Treatments

In severe cases, surgery may be necessary to relieve the compression. Surgical options include:

  • Transaxillary First Rib Resection: Removing part of the first rib to create more space.
  • Supraclavicular Approach: Accessing the thoracic outlet above the collarbone to remove scar tissue or release muscle tightness.

Who Treats Thoracic Outlet Syndrome?

Depending on the severity and type of the condition, Thoracic Outlet Syndrome is typically treated by specialists such as vascular surgeons, orthopedic surgeons, neurosurgeons, physical therapists, and pain management doctors.

  • Vascular Surgeons: Experts in treating blood vessel compressions.
  • Orthopedic Surgeons: Specialists in musculoskeletal issues.
  • Neurologists: Doctors who focus on nerve-related symptoms.
  • Physical Therapists: Professionals who provide rehabilitation and exercise programs.

How Long Does Thoracic Outlet Syndrome Last?

Patients often ask, “How long does thoracic outlet syndrome last?” The duration of Thoracic Outlet Syndrome (TOS) varies widely. With early diagnosis and proper treatment, some patients experience significant improvement within a few months. However, chronic cases may require ongoing management and more extended recovery periods. Surgical patients typically see improvements within weeks to months post-surgery, although full recovery can take up to a year or more.

Contact a Thoracic Outlet Syndrome Specialist in California

Thoracic Outlet Syndrome can significantly impact your quality of life, but understanding its symptoms and treatment options can help you manage it effectively. It is crucial to recognize the symptoms early and seek treatment from experienced thoracic outlet syndrome experts in California.
If you are experiencing any symptoms of Thoracic Outlet Syndrome, don’t hesitate to seek expert care. Contact a thoracic outlet syndrome specialist in California today to schedule a consultation. Encino Vascular Institute and Vein Center diagnoses and treats thoracic outlet syndrome using minimally invasive procedures. Early intervention can make all the difference in managing your symptoms and improving your quality of life. Book an appointment with our Thoracic Outlet Syndrome experts to take the first step toward relief and recovery!

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