Thoracic Outlet Syndrome Program

Do you need evaluation of symptoms potentially caused by thoracic outlet syndrome (TOS)? Our expert vascular surgery team at UMass Memorial Medical Center in Worcester, MA, can assess, diagnose and treat all types of thoracic outlet syndrome, providing relief for patients.

What is Thoracic Outlet Syndrome

TOS is a set of symptoms in the shoulder, arm or hand that occur from a narrowing of the thoracic outlet. This is the space between your collarbone and your first rib. An artery, vein or nerve can get pinched by the bones, resulting in symptoms and problems.

There are three types of TOS, depending on what part of the anatomy is affected: nerves, veins and arteries.

• Neurogenic thoracic outlet syndrome (NTOS), the most common type of TOS, occurs when the nerves are pinched. This can be hard to diagnose with patients experiencing symptoms for quite some time.
• Venous thoracic outlet syndrome (VTOS) is not as common but can be the underlying reason why a person develops a deep vein thrombosis (blood clot) in their arm. An early diagnosis is key in treating VTOS. 
• Arterial TOS is very rare. This occurs when an artery is pinched.

Symptoms of Thoracic Outlet Syndrome

Symptoms related to the compression of blood vessels and nerves include:
• Pain or aching in your neck, shoulder, arm or hand
• Pain, numbness, or tingling of your fingers, most often the pinky
• Hand weakness
• Limited range of motion in your arm
• Swelling and discoloration of your arm
• Pale and cool arm and hand

Types of Treatment

Our goal is to help relieve bothersome symptoms caused by thoracic outlet syndrome to improve function and quality of life. Treatments include:
• Physical therapy to help strengthen shoulder muscles, improve posture and reduce spasm in the muscles near the thoracic outlet
• Medicine to relieve muscle spasms
• Changes to daily activities that bring on symptoms
• Removing blood clots (minimally invasive thrombectomy)
• Surgical decompression, which includes removing a part of a muscle, the first rib or a fibrous band
• Repairing blood vessels

When to Call Your Health Care Provider

Call your primary care doctor right away if you have any of these issues:
• Your arm or hand is suddenly cool, abnormal in color, or swollen
• Sudden weakness of your hand
• Symptoms that don’t get better with therapy
Your provider can refer you to our vascular surgery team for further treatment.