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Thoracic outlet syndrome (TOS)

Our peripheral nerve surgeons at the Wellington Hospital are leading experts at treating thoracic outlet syndrome

About

Thoracic outlet syndrome (TOS) is where compressed nerves and blood vessels between your collarbone and first rib cause neck and upper limb pain. It also causes neurological problems such as numbness in the arm and hand, and reduced function.

Need to know

  • Symptoms of thoracic outlet syndrome icon plus

    Trauma such as a car accident, repetitive movement such as weight-lifting and a particular anatomy of the neck can cause TOS. However, a main cause is a cervical rib. This is a rare condition where an extra rib grows from the neck. This presses down on the nerves and blood vessels causing pain.
  • Diagnosis icon plus

    Your consultant will discuss your symptoms with you to help make a diagnosis. They will ask questions about your medical history and the types of pain you've been having. In TOS, it's often easier to rule out other neurological conditions first. They may order:

    • an x-ray of your chest to look for a cervical rib
    • an MRI scan of the brachial plexus
    • nerve conduction studies to identify TOS and to rule out carpal tunnel or neck irritation (cervical spondylosis) might be of use
  • Potential treatment options icon plus

    Pain relief and physiotherapy can be an effective cure for TOS. However, if your symptoms do not get better, your consultant may advise surgery. Thoracic decompression surgery treats TOS. Here, your surgeon makes an incision in your neck, parting the muscles and removing the compression of the brachial plexus (the five main nerves that supply the whole of the upper limb). If a cervical rib is compressing the nerves, it will also be removed.
Consultant in theatres

Our consultants

We're proud to work with leading experts across a range of medical fields, whose skills are matched by their integrity and compassion.

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From complex surgery to straightforward procedures, we provide exceptional care across our network of hospitals, outpatient centres and specialist clinics.

Request an appointment

We're happy to help you make an appointment with one of our experienced consultants.

This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
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