Thoracic Outlet Syndrome

Thoracic Outlet Syndrome is a rare condition that occurs when the blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) become compressed. It causes pain in the neck and shoulder, numbness and tingling in the fingers, and a weak grip.

Blood vessels and nerves coming from the spine or major blood vessels of the body pass through a narrow space near your shoulder and collarbone on the way to the arms. Sometimes, there is not enough space for the nerves to pass by or through the collarbone (clavicle) and upper ribs. Pressure on these blood vessels or nerves can cause symptoms in the arms or hands.


People with this condition have injured the area in the past or overused the shoulder. Common causes of thoracic outlet syndrome include physical trauma from a car accident, repetitive use from a job or sports, certain anatomical defects (such as having an extra rib), and pregnancy.


Thoracic outlet syndrome may cause:

  • Neck, shoulder or arm pain
  • Numbness in the arm, hand or fingers
  • Impaired circulation to the extremities (causing discoloration)
  • Weakness in the shoulders, arm, and hands
  • Swelling of the entire arm and shoulder


Thoracic outlet syndrome can be hard to diagnose, but the vascular specialists at University of Maryland are experts at identifying and recommending appropriate treatment options.

Medications and physical therapy are often used to treat this condition. However, if medical therapy doesn’t work or there are blood clots present, surgery may be the best option. Surgery may be performed to remove the first rib and make more room for the vessels and nerves. Surgery may also be performed to repair any structural problems of the artery or vein.

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