Thoracic Outlet Syndrome Program

Specialized Treatment for Thoracic Outlet Syndrome

If you’re living with the pain, tingling and weakness of thoracic outlet syndrome (TOS), it’s time to get help. At UMass Memorial Health, our vascular surgeons specialize in diagnosing and treating this uncommon condition. In fact, we’re one of only a few programs in the region with the ability to treat all types of TOS. You don’t have to travel far for comprehensive care from a skilled team. 

What Is Thoracic Outlet Syndrome? 

TOS describes a group of symptoms caused by compressed veins, arteries or nerves in your thoracic outlet, the space between your collarbone and first rib. TOS is usually the result of trauma, overuse injuries, tumors, or congenital conditions, such as rib abnormalities present at birth. 

There are three types of TOS: 

• Neurogenic thoracic outlet syndrome (compressed nerves)
• Venous thoracic outlet syndrome (compressed vein)
• Arterial thoracic outlet syndrome (compressed artery)

TOS that affects blood vessels is less common but more dangerous than neurogenic TOS. Venous or arterial TOS can cut off the blood supply to your upper limbs and increase your risk for blood clots and pulmonary embolism.

UMass Memorial Medical Center is home to one of only a few dedicated TOS programs in the region and the only program that treats all three forms of TOS. 

Thoracic Outlet Syndrome Symptoms

TOS can cause a range of symptoms, including: 

• Hand weakness
• Limited range of motion in your arm
• Pain or aching in your neck, shoulder, arm or hand
• Pain, numbness or tingling in your fingers
• Pale and cool arm and hand
• Swelling and discoloration of your arm

Diagnostic Tests for Thoracic Outlet Syndrome

TOS can be difficult to diagnose. The symptoms are similar to those of other, more common conditions, such as rotator cuff injuries or cervical spine problems. That’s why it’s so important to see a specialist who routinely evaluates and treats TOS.

Our vascular experts review your medical history and symptoms and do a comprehensive physical exam. Next, they may recommend imaging exams or neurological tests to gather more information about your condition. Thoracic outlet syndrome tests may include: 

• Chest X-ray
• Duplex ultrasound
• Electromyography
• CT angiography

Thoracic Outlet Syndrome Treatment

Conservative treatments often ease TOS symptoms. We may recommend physical therapy, medication, changes to your daily activities or nerve blocks. But people with severe symptoms due to venous or arterial TOS, or those with blood clots, may need surgery. 

We offer the following types of surgery for thoracic outlet syndrome: 

• Minimally invasive thrombectomy to remove blood clots
• Thoracic outlet syndrome decompression to remove the first rib or part of a muscle
• Vascular reconstruction to repair or replace damaged blood vessels