What can be mistaken for thoracic outlet syndrome?

Due to overlapping symptoms, several conditions can be mistaken for thoracic outlet syndrome (TOS). Some conditions that can present similar symptoms to TOS include:

1. Cervical radiculopathy: This condition occurs due to compression or irritation of the nerves in the neck, leading to pain, numbness, and weakness in the shoulder, arm, or hand. The symptoms can overlap with those of TOS.

2. Rotator cuff injuries or impingement: Shoulder injuries, such as rotator cuff tears or impingements, can cause shoulder and arm pain, weakness, and impaired range of motion. These symptoms can be similar to those experienced in TOS.

3. Brachial plexopathy: Brachial plexopathy refers to damage or dysfunction of the brachial plexus, a network of nerves that controls movement and sensation in the shoulder, arm, and hand. Symptoms can include pain, numbness, and weakness, resembling TOS.

4. Peripheral neuropathy: Nerve damage in the limbs, known as peripheral neuropathy, can result in pain, tingling, or numbness in the shoulders, arms, and hands. It can be mistaken for TOS when symptoms overlap.

5. Myofascial pain syndrome involves muscle and connective tissue, often causing localised pain and trigger points. It can lead to symptoms similar to TOS, including shoulder and arm pain.

It is crucial to consult with a healthcare professional for an accurate diagnosis and appropriate treatment, as these conditions can share similar symptoms but require different approaches for management.

What are the three special tests for thoracic outlet syndrome?

The three common special tests for thoracic outlet syndrome are:

1. Adson’s Test: This test is performed by palpating the radial pulse while the patient rotates their head toward the affected side and extends their neck. If the pulse diminishes or disappears, it may indicate the subclavian artery or brachial plexus compression in the thoracic outlet.

2. Roos Test (Elevated Arm Stress Test): The patient is asked to open and close their hands rapidly while holding their arms abducted to 90 degrees and externally rotated for 3 minutes. If the patient experiences significant pain, weakness, or numbness, it may suggest thoracic outlet syndrome.

3. Wright Test: In this test, the patient’s arm is brought into abduction and external rotation while the elbow is flexed. The examiner then applies downward pressure on the extended arm. It may indicate thoracic outlet syndrome if this reproduces symptoms like pain, numbness, or weakness.

Please note that a healthcare professional should perform these tests, as they require specific techniques and clinical judgment for accurate interpretation.

When do you suspect thoracic outlet syndrome?

Thoracic outlet syndrome is typically suspected when an individual experiences symptoms such as:

1. Pain or discomfort in the neck, shoulder, and/or arm.

2. Numbness or tingling in the fingers or hand.

3. Weakness in the affected arm or hand.

4. Swelling or discolouration of the hand or arm.

5. Difficulty moving the shoulder or arm.

If you are experiencing these symptoms or have concerns, I highly recommend consulting a healthcare professional for an evaluation and proper diagnosis. They will be able to consider your medical history, conduct a physical examination, and potentially order further diagnostic tests to confirm or rule out thoracic outlet syndrome.

What is thoracic outlet syndrome?

Thoracic Outlet Syndrome (TOS) is a condition that occurs when the nerves or blood vessels in the thoracic outlet area, located between your collarbone and first rib, become compressed or irritated. This can lead to various symptoms, including pain, numbness, tingling, weakness, or heaviness in the neck, shoulder, arm, or hand. Injury, poor posture, certain anatomical variations, repetitive activities, or underlying medical conditions often cause TOS. Treatment may involve physical therapy, medication, ergonomic modifications, or, in severe cases, surgery. It is always best to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan.

Can stress cause thoracic outlet syndrome? Yes, stress can contribute to the development or exacerbation of thoracic outlet syndrome (TOS). Thoracic outlet syndrome is a condition that occurs when certain nerves or blood vessels in the space between your collarbone and first rib (thoracic outlet) become compressed. Stress can lead to muscle tension, which can then increase the risk of compression on these structures. Additionally, stress can contribute to poor posture and repetitive movements, which can also put strain on the thoracic outlet area. It is important to manage stress levels and practice proper ergonomics to help prevent or manage thoracic outlet syndrome. However, it is always recommended to consult a healthcare professional for a thorough evaluation and accurate diagnosis.

Picture of Marco Scarci
Marco Scarci

Highly respected consultant thoracic surgeon based in London. He is renowned for his expertise in keyhole surgery, particularly in the treatment of lung cancer and pneumothorax (collapsed lung). He also specialises in rib fractures, hyperhidrosis (excessive sweating), chest wall deformities and emphysema.


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