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Thoracic Outlet Syndrome Center
If you don’t know much about Thoracic Outlet Syndrome (TOS), you’re not alone.
While an estimated 80 out of every 1,000 people in the United States has a form of TOS, there isn’t a widespread understanding of the disease process or a unified approach to treatment. Here’s a little refresher for anyone who has been told they have or might have TOS.
What is TOS?
Thoracic Outlet Syndrome occurs when blood vessels or nerves in the thoracic outlet (the space between the collarbone and the first rib) are compressed. This causes pain in the shoulders and neck and numbness in the fingers.
It takes great expertise to tell whether a patient is suffering from TOS or something else. The syndrome shares symptoms with rotator cuff injuries, cervical disc disorders, fibromyalgia, multiple sclerosis, tumors of the spinal cord and other conditions. In the Gulf South region, the level of expertise required to diagnose and treat TOS can only be found in one place: The Ochsner Thoracic Outlet Syndrome Center.
Why Ochsner for TOS Care?
Ochsner is home to the only team in the region that offers comprehensive diagnosis and management for patients with all forms of TOS. At the Ochsner Thoracic Outlet Syndrome Center, patients receive unparalleled care and experience stellar clinical outcomes.
As the leading health system in the region and an academic medical center, the Ochsner team has experience across various disciplines, including physical and occupational therapy, neurology, radiology, anesthesia and surgery. Orthopedic, sports medicine, neurosurgery and interventional cardiology specialists are also available as needed.
Get a Second Opinion
If you think you might have TOS and would like a second opinion, call 504-842-3966 for an evaluation.
Causes of TOS
Common causes of thoracic outlet syndrome include repetitive injuries from a job or a sport, physical trauma from an accident, anatomical defects (such as having an extra rib) and pregnancy.
Forms of TOS
TOS is divided into neurogenic and vascular types. The principle unifying factor is the anatomy of the thoracic outlet. The other commonality is the need for first rib resection in selected patients.
The majority of patients with TOS have the neurogenic form. These comprise 95% of the patients but only about 10% require surgery. About 5% of patients have vascular problems. Almost all of vascular patients require surgery and endovascular procedures and nearly all have thrombosis of the subclavian vein.
The diagnosis of vascular problems is fairly straight forward while the patients with neurogenic TOS are a challenge and require many different tests and evaluations. The principle therapy for neurogenic TOS is long-term physical therapy.
Our patients enter treatment for TOS after evaluation by Cardiothhoracic Surgery, Neurology, Vascular Surgery or Orthopedics. To verify or rule out TOS, your team may recommend diagnostic and therapeutic tests such as electromyography (EMG), nerve blocks, CT scan, MRI, surgery and endovascular procedures.
Treatment usually begins with physical therapy to relieve compression by strengthening chest muscles and restore normal posture. Your doctors might prescribe anti-inflammatory drugs for pain. Thromobolytics and anticolagulants might also be in order to break up or prevent blood clots. Finally, to release or remove the structures causing compression of the nerve or artery, your team may recommend thoracic outlet decompression surgery.