Thoracic outlet syndrome affects the nerves and blood vessels between your neck and upper arm. When the nerves are involved, which is 85-95% of the time, you develop chronic pain, tingling, and numbness in your arm, hand, neck, and shoulder. Anthony Echo, MD, with offices in Houston Methodist Hospital and the Willowbrook neighborhood of Houston, Texas, specializes in the diagnosis and treatment of neurogenic thoracic outlet syndrome. Call the nearest office or schedule an appointment online today to get treatment for thoracic outlet syndrome.
The thoracic outlet area starts in the lower part of your neck, runs under your collarbone, and extends to the upper part of your arm. When compression occurs in this region, you have thoracic outlet syndrome.
The thoracic outlet contains many nerves and blood vessels, giving rise to three types of thoracic outlet syndrome: neurogenic, venous, and arterial.
Dr. Echo treats neurogenic thoracic outlet syndrome and refers venous and arterial cases to his vascular surgery colleagues. In some cases, there may be a combination of structures compressed.
Neurogenic thoracic outlet syndrome occurs with compression of the brachial plexus. The brachial plexus is a network of nerves that control sensations and muscle movements in your hand, arm, and shoulder.
Thoracic outlet syndrome may develop due to:
Neurogenic thoracic outlet syndrome often occurs following injuries to the neck and upper arm. People engaged in sports such as swimming, baseball, tennis, and other throwing or overhead sports have a high risk of developing neurogenic thoracic outlet syndrome.
The most common symptoms of neurogenic thoracic outlet syndrome include:
The severity of your symptoms may vary during the day, but they get worse when you engage in activities that require overhead movements.
It’s also important to know that the vascular types cause different symptoms, including a bluish discoloration and swelling in your arm, sudden pain in your hand, and cold, numb, or tingling hands and fingers.
The physical changes responsible for your symptoms seldom show up on conventional diagnostic imaging such as MRIs or electrophysiological testing such as EMGs (electromyogram).
As a result, Dr. Echo diagnoses thoracic outlet syndrome primarily through reviewing your medical history and performing a physical exam. The goal is to rule out all the other possible causes for your symptoms, being careful to eliminate conditions of the spine and shoulder.
Though your first line of treatment may include physical therapy or chemodenervation with Botox®, neurogenic thoracic outlet syndrome seldom responds well to conservative therapies.
With fellowship training in microsurgery and peripheral nerve surgery, Dr. Echo specializes in surgery to decompress the affected nerves. During your procedure, he makes an incision above the collar bone, frees the nerves, and divides the scalene muscles (in your neck). In many cases, he also partially removes part of the first rib.
Most patients can return to their normal activities, including sports, in six weeks. But if your pre-surgery symptoms included weakness and numbness, your recovery may take longer.
If you develop arm, neck, or shoulder pain, call Anthony Echo, MD, or schedule an appointment online today for a thoracic outlet syndrome evaluation.