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All about Thoracic Outlet Syndrome (TOS): Overview

What is thoracic outlet syndrome (TOS)?

Sam Farres, M.D., Chair, Division of Vascular Surgery Mayo Clinic in Florida: Thoracic outlet syndrome is a condition where irritation or compression of nerves and vessel can happen within the thoracic outlet. And the thoracic outlet is the space between the collar bone and the first rib. So when this irritation or compression happens, it causes different kinds of symptoms that can be nerve in nature or vessel-related in nature and that's what caused the thoracic outlet syndrome phenomenon.

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What does thoracic outlet syndrome (TOS) feel like?

Dr. Farres: It varies from one person to the other person. It's a compression or irritation of nerves or vessels, and depends on which component is more compressed, can manifest in different presentation. If the nerve is compressed, it can manifest as pain or tingling, numbness. There is also other variation of that presentation. If a vessel is compressed – can be swelling, discoloration, coldness of the arms or the hand. Sometimes both component nerves and vessels can be compressed and when that happens, a variety of other symptoms can occur as well.

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Why does my collarbone hurt? Does thoracic outlet syndrome cause collarbone pain?

Dr. Farres: In theory, yes, it can cause collarbone pain, but I would like to emphasize that more common conditions can cause that in more frequency. So we have to be careful not to attribute collarbone pain just to the thoracic outlet. When it comes to the thoracic outlet, if the nerve component within the space gets compressed or irritated – if that is very adjacent to the collar bone – that can also contribute to the pain.

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