Thoracic Outlet Syndrome Research Paper

Pain and discomfort of the shoulder and entire upper extremity is a significant problem for many people and it can be attributed to a wide variety of causes1. The focus of this paper is to discuss the cause, symptoms, diagnoses, treatment and management of thoracic outlet syndrome (TOS). TOS is caused by a neurovascular compression event that can elicit pain, paraesthesia or discomfort in areas varying from the chest to the fingertips2,3. The ‘thoracic outlet’ is composed of three confined spaces that are potential entrapment sites for the neurovascular bundle. These sites are: the interscalene triangle, the costoclavicular space and the thoracocoracopectoral space2,3. Symptoms associated with thoracic outlet syndrome have been well documented
An appreciation and understanding of the complexity of the brachial plexus and its boundaries is paramount in differentiating the subtleties of the signs and symptoms of TOS3. The symptoms of both classic and non-specific nTOS vary greatly from individual to individual but there are there are certain symptoms that a patient suffering from TOS should present. According to research done by Watson, et al, there are four symptoms that nTOS patients typically show and of those four symptoms, three should be demonstrated by the patient before suspecting nTOS. These symptoms are: a history of aggravation with the arm in the elevated position (a feeling of relief tends to be expressed after the activity ceases), a history of paraesthesia originating from the spinal segments C8/T1, supreclavicular tenderness over the brachial plexus, and a positive hands up abduction/external rotation stress test5,7. Rare, but possible TOS symptoms include chest pain, tachycardia, dyspnea, dysphagia, occipital headaches, vertigo, dizziness and