Thoracic outlet syndrome is a term used for several different conditions that can occur when nerves and/or blood vessels in the thoracic outlet are compressed or irritated. The thoracic outlet is the space between your collarbone (clavicle) and your first rib. This narrow passageway is crowded with blood vessels, muscles, and nerves. If the shoulder muscles in your chest are not strong enough to hold the collarbone in place, it can slip down and forward, putting
pressure on the nerves and blood vessels that lie under it. This causes a variety of symptoms which together are known as thoracic outlet syndrome. Thoracic outlet syndrome can result from injury, disease, or a congenital problem, such as an abnormal first rib. It is more common in women than in men, and poor posture and obesity can aggravate the condition. Psychological changes are often seen in patients with thoracic outlet syndrome. It is not clear whether these changes are a cause or result of the syndrome. Symptoms may vary, depending on which nerves or blood vessels are compressed. Symptoms from nerve compression are much more common than symptoms from blood vessel compression.
Diagnosis of this condition can be more complicated than diagnosis of other more common shoulder conditions because there may be many symptoms to explain. Your doctor's evaluation will include an extensive medical history, physical examination, and diagnostic testing. Medical History and Physical ExaminationYour doctor will ask you about the history of your symptoms, perform a thorough physical examination, and try to reproduce your symptoms by examining your arm and hand in several positions. TestsElevated arm stress test. A test doctors often use to help them identify thoracic outlet syndrome is the elevated arm stress test. Your doctor will have you raise your arms over your head, then open and close your fists for approximately 3 minutes. If this reproduces your symptoms, it is possible that you have thoracic outlet syndrome. However, people who do not have thoracic outlet syndrome may sometimes have a positive test. Imaging tests. To better see and evaluate the bones, muscles, tendons, and blood vessels, your doctor may order imaging tests. These may include x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, and/or ultrasound. Additional tests. Your doctor may order special blood circulation tests and nerve conduction tests to help make the diagnosis. Treatment for thoracic outlet syndrome usually does not include surgery. Nonsurgical TreatmentPhysical therapy. Exercises can help strengthen the muscles surrounding the shoulder so that they are better able to support the collarbone. Postural exercises can help you stand and sit straighter, which lessens the pressure on the nerves and blood vessels. Nonsteroidal anti-inflammatory medications. Drugs like naproxen and ibuprofen can ease the pain and reduce swelling. Weight loss. If you are overweight, your doctor may recommend that you begin a weight loss program. Being overweight can stress the shoulder muscles that support your collarbone. Lifestyle changes. You may need to change your workstation layout, avoid strenuous activities, and even modify everyday activities that aggravate your symptoms. Surgical TreatmentIf nonsurgical treatment does not relieve your symptoms, your doctor may offer surgery. Surgery for thoracic outlet syndrome may involve removing a portion of an abnormal first rib, releasing a muscle that joins the neck and chest, or sometimes both. If you have symptoms of thoracic outlet syndrome, avoid carrying heavy bags over your shoulder because this depresses the collarbone and increases pressure on the important structures in the thoracic outlet. You should also do some simple exercises to keep your shoulder muscles strong. Here are four that you can try—10 repetitions of each exercise should be done twice daily:
As with all exercise programs, if any of these movements cause pain, stop immediately. Can collarbone pain be heart related?In some cases, collarbone pain may be a symptom of a serious or life threatening condition that needs immediate evaluation in an emergency setting. These include: Heart attacks: Heart attack symptoms can include pain that radiates from the chest up to the shoulder, usually on the left side.
Why does the left side of my neck and collarbone hurt?Pain in the right or left side of your neck is usually nothing serious. It's often caused by muscle strain, poor sleeping position, or bad posture. If the pain continues for more than a few days, see a doctor for recommendations on medical treatments as well as home-based remedies.
What is located under left collar bone?The thoracic outlet is a narrow space between your collarbone (clavicle) and your first rib. Nerves and blood vessels exit from your chest to your arm through this space.
Why does my left collarbone and shoulder hurt?Pain in the collarbone most likely occurs from a traumatic injury like a fracture, dislocation, or strain. Other common causes of clavicle pain include a frozen shoulder, rotator cuff tendonitis, or even a shoulder strain. Read below for more information on causes and how to treat pain in the collarbone and shoulder.
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