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Numbness in hands
A pinched nerve
Tingling
Numbness in the shoulder
Tingling in the arm
Leg pain
Painful shoulder
Not seeing your symptoms? No worries!
What is Thoracic Outlet Syndrome?
Compression of nerves and/or blood vessels at the base of the neck, causing symptoms like arm numbness. Symptoms worsen or occur when arms are raised, as this action increases pressure in the base of the neck. Causes include tumors, increased muscle or fat in the region, and abnormal ribs at the top of the ribcage.
Typical Symptoms of Thoracic Outlet Syndrome
- Numbness in the region from shoulder to elbow
- Numbness anywhere from the elbow to the wrist
- Numbness in the fingers
- Numbness or tingling in the arms
- Numbness or tingling
- Neck pain or stiffness
- Moving the arm / shoulder worsens the pain
- Shoulder pain more severe when lifting arm by itself than when supported by other hand
Diagnostic Questions for Thoracic Outlet Syndrome
Your doctor may ask these questions to check for this disease:
- Do you have numbness from shoulder to elbow?
- Do you have numbness in your arm?
- Do you experience numbness in your fingers?
- Do you have numbness or tingling in your arms?
- Have you been experiencing any numbness or tingling?
Treatment of Thoracic Outlet Syndrome
Treatment depends on the cause. Symptoms can be managed with physical therapy and activity modification, but surgery is sometimes indicated to treat the cause. This is often diagnosed in overhead athletes or workers, and can result in decreased performance or activity related symptoms.
Reviewed By:
Kent C Doan, MD (Orthopedics)
Dr Doan Graduated from the University of Missouri Kansas City School of Medicine and completed residency training in Orthopedic Surgery at the University of Colorado. He completed additional fellowship training in Orthopedic Sports Medicine at the prestigious Steadman Clinic and Steadman Philippon Research Institute in Vail, Colorado. He is a practicing Orthopedic Surgeon who specializes in complex and revision knee and shoulder surgery at the Kansas City Orthopedic Institute. He also holds an assistant professorship at the University of Kansas City.
Yoshinori Abe, MD (Internal Medicine)
Dr. Abe graduated from The University of Tokyo School of Medicine in 2015. He completed his residency at the Tokyo Metropolitan Health and Longevity Medical Center. He co-founded Ubie, Inc. in May 2017, where he currently serves as CEO & product owner at Ubie. Since December 2019, he has been a member of the Special Committee for Activation of Research in Emergency AI of the Japanese Association for Acute Medicine. | | Dr. Abe has been elected in the 2020 Forbes 30 Under 30 Asia Healthcare & Science category.
Content updated on Mar 31, 2024
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Hand numbness
- Numbness in the fingers
- Numbness
- The fingers of both hands are numb
- Hand tingling
- Finger numbness
- Hands are numb after sleeping in an awkward position
- The middle finger of the left hand is numb
- Off balance
- Arms are numb
- Numbness in left hand
- Numbness from elbow to wrist
- Wrist numbness
- The left half of the body is numb
- Ulnar tunnel syndrome
See full list
Symptoms Related to Thoracic Outlet Syndrome
Diseases Related to Thoracic Outlet Syndrome
FAQs
Q.
Thoracic Outlet Syndrome? Why Your Nerves Are Pinched + Medical Next Steps
A.
Thoracic outlet syndrome is nerve or blood vessel compression between your collarbone and first rib that can cause arm and hand pain, numbness, weakness, and sometimes swelling or color changes. There are several factors to consider; see below to understand more, including how to tell neurogenic from vascular types, urgent red flags that need immediate care, and the right next steps such as posture based physical therapy, ergonomic changes, medications, injections, and when surgery is appropriate.
References:
* Al-Hassani A, AlShamsi A, Alsafar D, Al-Shamma S, Al-Shamma A. Neurogenic thoracic outlet syndrome: a narrative review. Pain Physician. 2023 Jul;26(4):319-325. PMID: 37603332.
* Brant M, Hachey B, Sawan P, LeBlanc MR, Dellon AL, Patel A, Belzberg AJ, Zadeh Z. Neurogenic Thoracic Outlet Syndrome: Updates in Diagnosis and Treatment. Semin Plast Surg. 2022 May;36(2):98-107. doi: 10.1055/s-0042-1744436. Epub 2022 Feb 22. PMID: 35194371; PMCID: PMC8858102.
* Hood DB, Illig KA, Thompson RW, Freischlag JA, Davies MG, D'Souza S, Karwowski JK, Kibbe MR, Oderich GS, Rigberg DA, Upchurch GR Jr, White RA, Woo K. Diagnosis and Treatment of Thoracic Outlet Syndrome. JACC Case Rep. 2021 Jun 16;3(6):844-859. doi: 10.1016/j.jaccas.2021.03.012. PMID: 34164627; PMCID: PMC8214210.
* Shemesh S, Brooks M. Thoracic outlet syndrome: current concepts and imaging findings. Skeletal Radiol. 2020 Oct;49(10):1545-1555. doi: 10.1007/s00256-020-03487-1. Epub 2020 Aug 10. PMID: 32770281.
* Illig KA, Thompson RW, Freischlag JA, Donahue DM, Jordan SE, Edgelow PI, Sanders RJ, Gelabert HA, Zdeblick TA, Davies MG, Woo K, Clark N. Thoracic Outlet Syndrome. Ann Vasc Surg. 2016 Jan;30:1-10. doi: 10.1016/j.avsg.2015.06.014. Epub 2015 Oct 19. PMID: 27045110.
Q.
Scapula Pain? Why Your Shoulder Blade Hurts & Medically Approved Next Steps
A.
Shoulder blade pain is most often from muscle strain, poor posture, or rotator cuff problems, but can also come from a pinched neck nerve, thoracic outlet syndrome, arthritis, or referred pain from the heart, lungs, gallbladder, or pancreas; many cases improve with rest, posture correction, gentle stretching, and short term use of ice or heat and NSAIDs. Seek urgent care for chest pressure, shortness of breath, sweating, nausea, lightheadedness, new arm weakness or numbness, severe or worsening pain, or after trauma, and see a doctor if symptoms last more than 1 to 2 weeks. See below for the medically approved next steps and red flags, including when to try physical therapy versus imaging, since these details can change your best next move.
References:
* Visser M, de Vroome M, Veldhuijzen J, Visser C, Willems W, den Boer N, van der Horst A. Pain in the shoulder region: aetiology and diagnostic approach. J Int Med Res. 2021 Jul;49(7):3000605211029272. doi: 10.1177/03000605211029272. PMID: 34261362; PMCID: PMC8290333.
* Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Scapular Dyskinesis: Current Concepts. Br J Sports Med. 2023 Jul 26:bjsports-2022-106596. doi: 10.1136/bjsports-2022-106596. Epub ahead of print. PMID: 37495393.
* Neves MC, Silveira P, Capelo R, Paiva I. Shoulder pain and cervical spine: review of evidence. Rev Bras Ortop (Sao Paulo). 2023 Apr 17;58(5):e20230058. doi: 10.1055/s-0043-1768452. PMID: 37072481; PMCID: PMC10467144.
* Shah JP, Thaker N, Heimur R, Aredo JV, St. Luce Y, Audette JF. Myofascial Pain Syndrome: A Comprehensive Review. PM R. 2015 Sep;7(9):S91-S102. doi: 10.1016/j.pmrj.2015.06.006. Epub 2015 Jul 1. PMID: 2636254.
* Picavet F, Honsbeek S, Vermeulen K, de Vet HCW, Ostelo RWJG, Koes BW, Veldhuizen J, van der Steen M, van der Horst A. Clinical Practice Guidelines for the Management of Shoulder Pain: A Systematic Review. Spine (Phila Pa 1976). 2022 Apr 1;47(7):519-530. doi: 10.1097/BRS.0000000000004245. PMID: 34914841.
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Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Collins E, Orpin M. Physical Therapy Management of Neurogenic Thoracic Outlet Syndrome. Thorac Surg Clin. 2021 Feb;31(1):61-69. doi: 10.1016/j.thorsurg.2020.09.003. PMID: 33220772.
https://www.thoracic.theclinics.com/article/S1547-4127(20)30077-3/fulltextKuhn JE, Lebus V GF, Bible JE. Thoracic outlet syndrome. J Am Acad Orthop Surg. 2015 Apr;23(4):222-32. doi: 10.5435/JAAOS-D-13-00215. PMID: 25808686.
https://journals.lww.com/jaaos/Fulltext/2015/04000/Thoracic_Outlet_Syndrome.4.aspxVanti C, Natalini L, Romeo A, Tosarelli D, Pillastrini P. Conservative treatment of thoracic outlet syndrome. A review of the literature. Eura Medicophys. 2007 Mar;43(1):55-70. Epub 2006 Sep 24. PMID: 16955064.
https://www.minervamedica.it/en/journals/europa-medicophysica/article.php?cod=R33Y2007N01A0055