Thoracic outlet syndrome is when you have pain, swelling, or other symptoms from compression in your thoracic outlet - the opening in between your lower neck and upper chest. The cause is pressure in the neck against the nerves and capillary that most likely to the arm. There are three types of TOS relying on which structure is being compressed: 1. Neurogenic TOS-nerve compression comprises 95% of all TOS patients. Venous TOS-compression of the mother lode consists of 4% of all TOS patients. Arterial TOS-compression of the main artery makes up less than 1% of all TOS patients. Vascular TOS is a term often used however there is no such entity as vascular TOS. The term describes TOS due either to compression of an artery or vein. The ideal terms, arterial or venous, should be employed and the term vascular disposed of. The three types of TOS are very different from each other. Each will be explained separately. Neurogenic TOS provides with pain, weakness, pins and needles and prickling in the hand and arm. Additionally, neck pain and headache in the rear of the head prevail. Venous TOS, also understood as Paget-Schroetter disease, presents with arm swelling, blue or dark discoloration, and a feeling of volume or hurting in the arm. Arterial TOS presents with coldness, numbness, prickling, pain, and white staining in the fingers or entire hand. Cramping of the lower arm and hand with activity is common. Pain usually entails the hand and arm, but not the neck or shoulder.
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