Postural exercises can help you stand and sit straighter, which lessens the pressure on the nerves and blood vessels.Exercises can help strengthen the muscles surrounding the shoulder so that they are better able to support the collarbone.Treatment for thoracic outlet syndrome usually does not include surgery. In some health care institutions, thoracic outlet syndrome is diagnosed and treated by a multidisciplinary team that includes an orthopaedic surgeon, a physical medicine and rehabilitation specialist (PM&R specialist, or physiatrist), physical therapists, a peripheral nerve surgeon, and/or a vascular surgeon. In some cases, your doctor will perform many tests to rule out other conditions with similar symptoms, such as pinched nerves in your neck or blood clots. Often, there is not a clear and obvious way to diagnose thoracic outlet syndrome. Your doctor may order special blood circulation tests and nerve conduction tests to help make the diagnosis. To better see and evaluate the bones, muscles, tendons, and blood vessels, your doctor may order imaging tests. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010. Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Overhead activities are particularly difficult because they worsen both types of compression as the rib, collarbone, and/or shoulder blade compress the nerves and blood vessels.Less commonly, pressure can reduce the blood flow into your arm and hand, making them feel cool and easily fatigued (tired). Pressure on the blood vessels can reduce the flow of blood out of your arm, resulting in swelling, redness, or other discoloration of your arm.Weakness that may make your hand clumsy.Pain, numbness, or tingling on the inside of the forearm and the fourth and fifth fingers of the hand.A vague, aching pain in the neck, shoulder, arm, or hand.Pressure on the nerves (brachial plexus) may cause:.The following are common signs of thoracic outlet syndrome: Symptoms from nerve compression are much more common than symptoms from blood vessel compression they are also easier to diagnose. Which symptoms you have often depends on which nerves or blood vessels are compressed. Patients with thoracic outlet syndrome often experience a variety of symptoms.
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