A vascular surgeon specializes in diseases of the circulatory system. You may see a vascular surgeon, physical therapist, and neurologist. DON’T miss follow-up health care provider appointments. ![]() DON’T put heavy objects (e.g., backpacks) on your shoulders for long periods.DO call your health care provider if you need a referral to a specialist.DO call your health care provider if you have arm pain a cold, pale extremity or numbness and swelling of your arm.DO understand that in the most cases, recommended treatment will involve a conservative approach with special exercises to strengthen your shoulder and posture.DO realize that thoracic outlet syndrome isn’t very common.DOs and DON’Ts in Managing Thoracic Outlet Syndrome: In certain cases (e.g., compression of the vein with a blood clot), the health care provider may suggest using a blood thinner called warfarin to prevent more clots. Surgery may be done for vascular or major nerve difficulties, but it’s used for only a few people. Treatment of nerve compression is usually conservative. Treatment aims to fix abnormalities in posture that may contribute to compression and to develop an exercise program to strengthen shoulder muscles. In venography, dye is injected into the vein. In arteriography, dye is injected into the artery. Scans may include chest computed tomography (CT), mainly to rule out other disorders. ![]() The health care provider makes a diagnosis with the medical history, physical examination, blood tests, X-rays, and special imaging scans. How Is Thoracic Outlet Syndrome Diagnosed? Vein compression causes swelling and pain of the arm. Artery compression causes a pale skin color, coolness, and numbness of the arm. The artery or vein is rarely affected alone. Pain gets worse with use of the arm, and the arm often gets tired. Fingers can get numb and tingle, and the grip can get weak. Hand pain is often worst in the fourth and fifth fingers. Symptoms include pain in the shoulder, arm, or hand, or in all three. What Are the Symptoms of Thoracic Outlet Syndrome? ![]() The syndrome isn’t passed from parents to children and isn’t contagious. Shoulder and collarbone problems from injuries, trauma, or carrying heavy backpacks for long periods can cause it. What Causes Thoracic Outlet Syndrome?Ĭauses include an abnormal muscle position, an abnormal congenital rib in the neck, blood clots, and abnormalities of the first rib. The syndrome is more common in women 20 to 50 years old. The nerve is affected most, 95% of the time. The artery takes blood away from the heart. Symptoms depend on whether the nerves, artery, or vein is compressed. The brachial plexus is the space between the collarbone and first rib, where nerves and blood vessels pass into the arms from the neck. Thoracic outlet syndrome consists of symptoms caused when nerves or blood vessels in the brachial plexus are compressed (squeezed).
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