Thoracic outlet syndrome consists of symptoms caused by compression of the nerves in the brachial plexus (nerves that pass into the arms from the neck) or blood vessels. Patients may have pain in the shoulder, arm or hand, or in all three locations.
The hand pain is often most severe in the fourth and fifth fingers. The pain is aggravated by the use of the arm and "fatigue" of the arm is often prominent.
The prognosis for the majority of individuals who receive therapy for thoracic outlet syndrome is good.
The goals of treatment are two-fold: to correct postural abnormalities that might contribute to the compression and to establish an exercise program to strengthen the shoulder muscles.
Most often a conservative course of treatment is followed. If vascular or major neurological impairment is present, surgical decompression may be considered. However, only a small number of patients require surgery.
(Reviewed by Dr Andrew Rose-Innes, Department of Neurology, Yale University School of Medicine)