What is TOS? What Are the Signs and Symptoms of TOS

Thoracic outlet syndrome is no joke; if you have it, it doesn’t just cause shoulder and neck pain but can also lead to tingling in your fingers and many other symptoms such as dizziness, ear pain, elbow pain, and even. According to the National Library of Medicine Academic Thoracic Outlet Center‘s prospectively maintained database, approximately 3 and 1 per 100,000 people worldwide have a diagnosis of TOS. I happen to be the “one” in 100,000 people. I feel like part of why it is so “rare” is more so because of how few of people are aware of the symptoms.

I am going in for surgery on my right side today followed by a week long hospital stay. I had surgery on my left side back in August and am still recovering from that surgery. I have bilateral TOS and Pec Minor Syndrome (which often go hand in hand). To be real honest, the surgery is brutal. I had a chest tube, stayed in the ICU for several days before being transferred to a step down unit. It is invasive and takes a long time to heal. I wanted to write this article to help make TOS known so others do not deal with the same cycle of having odd symptoms and being looked at like they are crazy by a doctor. I will very quickly share about my own story and then we will jump right into the facts pertaining to TOS.

For several years, I’ve had quite a few unexplainable symptoms. I will see one doc and they send me to another and then another. No one could explain why any of it was happening. Another new symptom would arise that seemingly had no correlation to any of my other symptoms. Until now. It all makes sense and they FINALLY, after a medical consultation with a vascular surgeon, have put the pieces together (and ran the right tests to prove their case).

Here are a list of my symptoms. Many aren’t listed on google as typical symptoms but I made a list for my vascular surgeon who specializes in TOS and he said they are all part of TOS.

Headaches (I wake up feeling like I’ve been beat in the back of the head but sleep study didn’t show a need for a cpap)

Jaw pain (I even did an emergency dentist appt thinking I had a bad abscess from the pain-nothing wrong with my teeth)
Ear pain
Ringing in the ears
Bulging muscles in the neck
Numbness of face and lips
Drastic eye and even facial twitches
Pulling of the jaw
Extreme Dizziness
Off balance most of the time
EXTREMELY muscles in my neck, shoulders and upper back
Muscle spasms in my neck, shoulder, and hand
Elbow pain (like I’ve hit my funny bone non stop)
Shoulder pain
Chest pain
Fatigue
Costochondritis
Muscle wasting in hand/arm
Muscle weakness in hand (have a hard time holding stuff in my left hand- and starting in my right)
Burning under the arm and arm pit
Numb patch on my back
Knotting of muscles under the shoulder blade
Color changes in arm/hand
Very low blood pressure
Swelling of fingers (despite low blood pressure)
PVCs (premature heart beats)
Rapid heart rates/very slow heart rate in the low 40’s… sometimes in upper 30’s
Numbness of hand
Bicep pain and knots
Enlarged veins on chest
Varicose veins quickly came up on my legs – the only one of these that they say they don’t think it has anything to do with it but many of the people I’ve met in the TOS support group said the same thing happened with them.

I had surgery in August but because I am very high risk for developing ulcers, I am unable to take ANY NSAIDS, making the healing process very long and very difficult. After my first surgery, the symptoms began showing up full blast on my right side including my hand turning a purplish blue color. They ordered more testing and sure enough, there is compression on the right side.

General Overview of TOS

TOS occurs when the vital blood vessels or nerves in the thoracic outlet become compressed, blocking off their proper flow of circulation and disrupting the tissue function. It’s a serious problem, so if you’re experiencing any shoulder discomfort or numbness in your fingers, don’t hesitate to seek medical advice as soon as possible. Identifying and managing TOS at an early stage can help reduce symptom severity and gradually allow you to get back to normal activity.

Thoracic outlet syndrome is a painful condition caused by pressure on nerves located in the neck and upper chest. Although its exact cause is sometimes unknown, common contributors to thoracic outlet syndrome include physical trauma from car crashes, repeated injuries from work or sports activities, certain anatomical anomalies such as an extra rib, and pregnancy. The condition can have serious implications for sufferers as it affects the shoulders, arms, neck and hand. Depending on the severity of the symptoms experienced by an individual patient, treatment may involve medications or even surgery to remedy this often very troubling malady.

Treating thoracic outlet syndrome typically requires physical therapy and pain relief medication. For the vast majority of people, these treatments are highly effective in relieving their symptoms. However, depending on your specific condition and the severity of your symptoms, your doctor may suggest that surgery is a better option for you. Surgery to correct thoracic outlet syndrome often involves removing tissue from around the shoulder or clavicle which can help to alleviate pressure in the chest area. It may also provide lasting relief from your symptoms in some cases, though it is important to talk to your doctor before making any decisions about surgery.

Symptoms

There are three different types of thoracic outlet syndrome (TOS):

Neurogenic (neurologic) thoracic outlet syndrome (nTOS). Neurogenic Thoracic Outlet Syndrome (nTOS) is the most common type of thoracic outlet syndrome, and can result in compression of the brachial plexus. The brachial plexus is an important part of our nervous system, as it controls muscle movements and sensation in our shoulders, arms, hands and beyond. Those suffering from nTOS may experience a wide range of symptoms, including pain in the neck, shoulder or arm; weakness in wrist/hand muscles; numbness or tingling sensations; a feeling that their arm is swollen; tenderness or changes at the base of their necks; and more. Knowing how to identify the signs and symptoms of nTOS can help people get a proper diagnosis faster so they can receive appropriate treatments and start regaining their quality of life.
Venous thoracic outlet syndrome (vTOS). VTOS can develop when the veins beneath your collarbone become constricted and form blood clots.
Arterial thoracic outlet syndrome (aTOS). This is the least frequent type of TOS, which materializes when one of the arteries beneath your collarbone experiences compression. This leads to a noticeable bulge in that artery, known as aneurysm.

It’s conceivable to experience a blend of the three various forms of thoracic outlet syndrome, with compression existing on several portions of the thoracic outlet.

Depending on the kind, there can be varying signs and symptoms of thoracic outlet syndrome. If nerves are being compressed, indications of neurogenic thoracic outlet syndrome might involve:

An inability to feel or a tingling sensation in your arm or fingers can be an indication that something is amiss.
Experiencing agony or stiffness in your neck, shoulder, arm, or hand
Weakened hand grip

Common signs and symptoms of venous thoracic outlet syndrome (vTOS) may include:

Blueish coloring of hand
Pain and swelling in your arm
A blood clot in the upper part of your body, such as a vein, can be dangerous. If you experience any symptoms or signs that indicate an impending blood clot, contact a medical professional immediately.
Fatigue in your arm and hand when being active
Whitish, blanched hue in one or more of your fingers on either hand?
An incessant lump close to your collarbone that causes you discomfort.

If you have arterial thoracic outlet syndrome (aTOS), the following signs and symptoms may present themselves:

Icy digits, palms or limbs
Pain in your hands and arms
If one or more of your fingers, or even the entirety of your hand appears pale in color or has a bluish tint to it, then this could be an indication that something is wrong
An absence or a weak pulse in the affected arm

When to see a doctor

If you experience any of the indications of thoracic outlet syndrome on a regular basis, it is important to seek medical advice from your doctor. Ask your PCP to refer you to a TOS specialist from this list below. You will want the best of the best when it comes to diagnosing and treating you with TOS. TOS surgeons are often Vascular doctors. You will want to seek out someone who specializes in TOS, especially if you are looking at surgery.

Causes

Thoracic outlet syndrome is typically caused by the compression of nerves or blood vessels in the region located beneath your collarbone (clavicle). This area is known as the thoracic outlet. The pressing factor can vary and may include:

Anatomical defects. Congenital anatomical defects are relatively common, with one of the most well-known examples being a cervical rib. This extra rib is placed above the first rib and can cause compressions in the nerves that pass through your neck and shoulders when it grows too large or out of proportion compared to the standard two ribs. Additionally, abnormal fibrous bands connecting your spine to your ribs (known as thoracic outlet syndrome) can sometimes develop at birth, resulting in uncomfortable muscular tension and potentially dangerous vein blockages in the region. Both these issues are serious enough that medical consultation should be sought if they persist or cause any discomfort. It’s important to remember though that despite these potential problems, congenital defects such as cervical ribs or thoracic outlet syndrome are usually nothing to worry about when spotted early enough.
Poor posture. Poor posture can wreak havoc on our bodies if we don’t address it right away. Thoracic Outlet Syndrome (TOS) is just one real world result of this little-discussed issue. Our thoracic outlet area is what connects our body from the neck down to the arm. When we start to develop that dreaded “slouch” by drooping our shoulders or holding our head in a forward position, it can cause debilitating tightness and discomfort for those suffering from TOS. It’s important move more and get up out of your chair throughout the day, as well as practice habits that encourage good posture at all times to avoid compressing that area of your body over time.
Trauma. Trauma is a difficult thing to experience, and those who go through it endure long lasting physical and emotional impacts. In the case of nerve-related trauma from a car accident, for example, the internal changes that occur can put pressure on certain nerves in the thoracic outlet. This can lead to symptoms like hand tingling and numbness, even though the accident may have been some time ago – sometimes with no immediately apparent link between the two, since we often don’t notice this kind of trauma until some time after it’s happened. While these effects can cause huge disruption to life, therapies exist that can help lessen any pain or distress they cause.

Risk factors

One of the most common causes of thoracic outlet syndrome (TOS) is related to sex and age. It appears that females are at greater risk for diagnosis, being three times more likely to be affected than males. Additionally, it’s often observed in adults between the ages of 20 and 50. Still, anyone can be diagnosed at any age; no one is off limits for TOS. Therefore, it’s important to familiarize yourself with the symptoms and visit your doctor should anything irregular present itself. Awareness can make all the difference in determining whether or not a person has this syndrome – ultimately leading them on a path toward proper treatment.

Complications

Complications from thoracic outlet syndrome (TOS) can vary depending on its presentation. Neurogenic TOS is when nerve compression or entrapment occur in the neck, shoulder, and arm area due to bony abnormalities or muscular disregulations. Venous and arterial TOS occurs when blood vessels become compressed due to either an anatomical abnormality or intense physical activity for prolonged periods of time. Although each type of TOS requires medical attention and evaluation, the former two are considered much more urgent. As soon as you experience any side effects correlating with TOS, it is important to seek out professional help right away – especially with venous or arterial types of presentations! Doing so will help ensure that you receive the correct diagnosis and treatment plan immediately, lessening the severity of your symptoms in the long run.

Prevention

Taking care of yourself is an important aspect of protecting your body and avoiding any possible complications from thoracic outlet compression. It’s imperative to avoid making heavy repetitive movements, like carrying a heavy bag back and forth or doing the same motions with your hands on a regular basis. If you are overweight, the best way to address it is by doing some form of physical exercise and decreasing your food intake. This will not only help with potential symptoms of thoracic outlet syndrome but also reduce your risk of more serious health problems in the long run. Taking proactive steps to keep yourself healthy and safe is crucial, as it is easier to do prevention than to seek treatment later on.

It’s essential to keep your shoulders strong and healthy, as this can help ward off thoracic outlet syndrome. An easy way to incorporate strengthening exercises into your daily routine is by setting aside time for stretches that focus on the chest, neck and shoulders. Although stretching won’t prevent all cases of thoracic outlet syndrome, it will strengthen key muscles involved in this condition and should be incorporated into any long-term prevention tactics you use against TOS. On top of this, try to avoid carrying heavy bags over one shoulder as much as possible – doing so raises pressure in the thoracic outlet and just isn’t worth the risk!

Diagnosis

When it comes to diagnosing thoracic outlet syndrome, it can often be difficult due to the sheer variance in symptoms and their severity. That being said, if you think you might have thoracic outlet syndrome, your doctor should be able to do a thorough review of your medical history and symptoms, as well as a physical examination. In some cases, additional testing such as imaging might also be necessary to make an accurate diagnosis. Don’t hesitate to reach out to your doctor for help determining whether or not you need further tests.

Physical examination. During a physical exam for thoracic outlet syndrome, your doctor will do more than just give you the usual check-up. They’ll be searching for signs that might indicate TOS, such as a dip in your shoulder, an abnormality in your collarbone’s bony structure, swelling or discoloration in any of your arms, or an abnormal pulse. Your doctor will assess your range of motion and use different techniques to replicate the symptoms you’re experiencing. By asking you to move or lift arms in certain directions, they can determine which movements trigger the discomforts you’re facing. Finding out which motions initiate the pain is key to determining whether or not you have TOS. Some specific testing that is often done during an initial visit with a vascular doctor are the Roos and Adson tests.
Medical history. If you’ve recently visited your doctor for suspected Thoracic Outlet Syndrome (TOS), be prepared to answer some detailed questions about your medical history. You’ll likely be asked about past illnesses and injuries, any medications or herbal supplements you take, as well as which physical activities or occupations you engage in. Your doctor will use all of this information to form a complete picture of your health condition so that they can make an accurate diagnosis and outline the next steps in your care. It’s important to give accurate and thorough answers to all of these queries in order to get the best care possible.
Brachial Plexus Block. By injecting local anesthetic into the scalene muscles of your neck, there is a greater chance of alleviating symptoms associated with neurogenic TOS. This numbness can be used to identify which areas are contributing to these unwanted sensations and help doctors determine if you will have success with surgery.

Imaging and nerve study tests

To rule out ailments associated with nerve damage such as carpal tunnel syndrome, cubital tunnel syndrome, cervical spine disease or other forms of nerve entrapment that could be mistaken for thoracic outlet syndrome, it is important to review the patient’s history. Depending on the case, further tests like a conduction study of nerves or MRI scans and other imaging may also need to be conducted.

To ascertain whether you have thoracic outlet syndrome, your doctor may suggest a few diagnostic tests such as:

Ultrasound. Ultrasounds are an incredible way for doctors to identify certain conditions within the body. An ultrasound is a diagnostic tool used to create images of your insides without having to go under the knife; it uses sound waves to provide info. When it comes to thoracic outlet syndrome, ultrasounds are in fact one of the first methods of medical detection. Doctors may use this test if they suspect you have vascular thoracic outlet syndrome or any other issues with the vessels. This type of imaging helps a physician narrow down their diagnosis so that they can focus treatment accordingly – making it easier for you to get relief from any health struggles.
X-ray. X-rays are an essential diagnostic tool used by healthcare professionals to find out what’s going on inside our bodies. They use a small amount of radiation to produce images of our organs and bones, allowing doctors to spot potential issues quickly. For example, a chest X-ray can be used to detect extra ribs or other irregularities in our upper body anatomy. What is interesting is that it can also be employed to diagnose conditions that cause symptoms like chest pain or shortness of breath. The uses of such imaging technology are therefore vast – they can help us pin down troublesome ailments before they become worse and provide us with peace of mind as well as tangible health benefits.
Computerized tomography (CT) scan. Computerized tomography (CT) scans are a valuable medical tool. Using X-rays, these scans create images of our internal organs and tissues that provide invaluable information, such as the location and cause of blood vessel compression. In certain cases, a dye is injected into a vein to help make more detailed images of the vascular system (known as CT angiography). With its noninvasive and highly accurate nature, CT scans remain one of the most reliable ways for doctors to quickly and accurately identify the root causes of many medical problems.
Magnetic resonance imaging (MRI). Magnetic resonance imaging (MRI) is an incredibly powerful diagnostic tool. It uses radio waves and magnets to create a detailed internal picture of the human body. This can be invaluable in helping diagnose numerous conditions; from vascular compressions to detecting congenital anomalies such as cervical ribs or fibrous bands connecting spinal column to ribs. Your doctor may use it when your head, shoulders and neck are placed in different positions so they can get a better view of the blood vessels in your arm. All in all, MRI is an incredibly powerful medical device that can help us better understand our bodies and identify issues before they become serious problems. You CAN have a normal MRI and still have TOS.
Magnetic Resonance Angiographies (MRA) Often, a doctor will have you complete an MRI and MRA on the same day. Medical MRAs, or Magnetic Resonance Angiographies, are specialized medical tests that allow doctors to get a detailed look at the blood vessels in patients. The technology works by using magnetic fields and pulses of radio waves to create images that can be used for diagnosing issues related to the heart, lungs, and other organs. To use this technology, the patient is placed inside a large tube and may need to receive an intravenous contrast material to get clear images from the test. This testing gives physicians more insight into their patient’s health, allowing them to make more accurate diagnoses so they can prescribe treatments as needed.
Arteriography and venography. Arteriography and venography are both processes used in medical diagnosis that take images of a patient’s blood vessels. During these tests, the doctor inserts a tiny catheter through a small incision, usually in the groin, to reach the designated artery or vein and inject dye for the X-ray imaging. While it can be uncomfortable or even a little frightening for some people, the procedure is painless and short, and incredibly helpful when it comes to understanding your vascular health. Radiologists can then use these images to identify abnormal narrowing, aneurysms, blockages, internal bleeding, clotting conditions and more. As such, they form an important part of today’s diagnostic toolkit.
Catheter. Many of us don’t think twice when we experience pain in our limbs or other areas, but it turns out it could be an indicator that there’s a problem with a vein or artery. Doctors are able to diagnose and treat issues like these by inserting a catheter into the vein or artery and checking for any clots that may be present. Thankfully, through this procedure, they can also deliver medications directly to the affected area to dissolve the clot and restore blood flow if necessary. It’s great to know that physicians have such advanced diagnosis and treatment procedures at their disposal!
Electromyography (EMG). Electromyography (EMG) is a medical test that is used to detect and diagnose muscle conditions or nerve damage. During this procedure, your doctor will insert a needle electrode into different muscles in your body. This test helps measure the electrical activity of your muscles when they are contracted or at rest. By tracking this activity, it can help find out information about any potential nerve damage you may have. EMGs can give physicians beneficial insight about overall musculoskeletal health and provide helpful information for diagnosing and treatment plans.

Treatment

For the majority of circumstances, an approach to therapy that is conservative may prove most successful and beneficial – especially if your condition has been identified early. Treatment could involve:

Physical therapy. Physical therapy is an effective, noninvasive way to address and treat a variety of health concerns, including neurogenic thoracic outlet syndrome. With physical therapy, a qualified practitioner will provide you with exercises meant to strengthen and stretch the muscles in your shoulder region specifically in order to improve range of motion and posture while also taking pressure off of the blood vessels and nerves in the thoracic outlet. The ultimate goal? To restore longterm functionality. In other words, it’s important to get treatment before any lasting damage can occur – physical therapy is definitely key here!
Medications. Taking medications seems like an easy solution to your pain, but it’s important that you understand the types of medications your doctor might prescribe. Anti-inflammatory drugs and pain medications are often the first option; they work to reduce swelling, ease discomfort and help with relaxation. In some cases, doctors may use blood-thinners if there is a clot present; this helps to keep the blood flowing properly to help mitigate any further complications. Ultimately, it’s important to listen closely to your doctor and pharmacist when taking these types of medications as not doing so could cause more problems down the road.
Clot-dissolving medications. If you have been diagnosed with venous or arterial thoracic outlet syndrome and, on top of it, are dealing with blood clots, your doctor may administer clot-dissolving medications, known as thrombolytics, into the veins or arteries to dissolve them. This would likely be done before other treatments begin in order to quickly break up the clots. After that is taken care of, they may move onto prescribing medications that help prevent future blood clots (anticoagulants) so that the same problem doesn’t occur again. Although the idea of giving drugs to break apart blood clots can sound daunting, these strategies have been proven to effectively treat this condition and get you on the road to recovery.

Surgical options

Surgery is usually a last resort, but sometimes it is the best course of action for certain medical issues. If conservative treatments have not been effective, if you are dealing with ongoing or worsening symptoms, or if your neurological problems are progressing, your doctor might recommend surgery. This type of procedure requires a highly skilled surgeon; you may either need a thoracic specialist for chest-related issues or a vascular specialist for blood vessel-related concerns. Although it can be scary to think about surgical intervention, the end result could potentially bring relief from those painful and troubling symptoms.

Thoracic outlet syndrome surgery may sound like a promising solution, but it has its risks. In addition to the potential for injury to the brachial plexus, there is also a chance that symptoms may not be relieved or may recur after the procedure is complete. It’s important to speak with your doctor about risks and benefits before undergoing thoracic outlet syndrome surgery, as it should not be taken lightly. That being said, for some individuals who have exhausted other treatment options and still experience severe discomfort due to their condition, surgery may be an effective last-ditch effort.

Thoracic outlet decompression is a common surgery to treat thoracic outlet syndrome. This type of surgery usually involves removing a portion of the first rib and a muscle to reduce the amount of compression on the surrounding nerves, blood vessels, and other tissues. In some cases, additional surgery may be necessary to repair any damage caused by compressing the blood vessels. Recovery time after this procedure can vary widely depending on the individual’s medical history, but typically patients are able to return to a somewhat normal routine within 3 months unless you are unable to take NSAIDS. This will prolong your recovery as the inflammation continues to restrict the nerves and blood vessels.

There will be limits with how much you can carry and restrictions on pushing or pulling anything for 3-6 months depending on your surgeon’s recommendations. Physical therapy is typically required for a full year. You will start off with manual therapy and then move towards resistance and strength building exercises with your PT.

Surgery for venous or arterial thoracic outlet syndrome may be a two-step process to ensure your safety. The first step is delivering medications to dissolve any blood clots that are present prior to thoracic outlet decompression. In some cases, the second step is removing a clot from the vein or artery or repairing the vein or artery with a special procedure before performing decompression. These steps help reduce risks like excessive bleeding and recurrent clots, so it’s important to follow your doctor’s instructions and get proper treatment if you’re dealing with this condition.

Having arterial thoracic outlet syndrome can be a challenging condition to deal with. It isn’t every day that you have major surgery, but depending on your individualized situation, it might be what you need to get back to having a pain-free life. Your surgeon may recommend replacing the damaged artery with a donor or artificial graft and sometimes this is done at the same time as having the first rib removed. Removing this bone is thought to unblock the area of circulation and restore normal blood flow. While it may seem intimidating, many patients are happy to learn that their recovery times are typically much faster than expected and they can continue along on the path towards restoration soon after the procedure.

Controlling inflammation post surgery

Controlling the inflammation is the biggest battle when it comes to post surgery healing. Use as much ice as you can to eliminate as much swelling as possible. The more swelling you have for prolonged periods of time result in scar tissue being able to form, restricting the blood flow and compressing the nerves even after the bones and muscles are removed.

Talk to your doctor about concerns regarding being unable to use NSAIDS. They can do toradol injections to help bypass the NSAIDS passing through your stomach. This will help with inflammation but can’t be given on a daily basis. Finding the right balance during recovery for someone who is unable to take NSAIDS due to liver issues or those who have had gastric bypass surgery in the past.

Lifestyle and home remedies

Whether you’ve been recently diagnosed with thoracic outlet syndrome or you think you may have the condition, your doctor or physical therapist are going to be crucial partners in your treatment and recovery. They’ll likely instruct you to do certain exercises at home that help support and strengthen the muscles around your thoracic outlet. This can increase mobility, reduce pain, and improve function. It’s essential that these exercises are done as prescribed, so make sure to ask questions about proper form and frequency before starting any new routine. With a little effort and perseverance, you can take control of your own healing process and make strides towards feeling better.

To prevent unnecessary tension in your neck, shoulders and muscles surrounding the thoracic outlet:

Maintain a good posture
Take many breaks from work that requires sitting or repeditive movements
Stay (or get to) a healthy weight range
Set up an ergonomic workspace that encourages good posture and minimizes strain on the body to enable symptom relief.
Unwind by giving yourself a soothing shoulder and thoracic outlet massage.
Utilize a heating pad or ice pack to ease the tender area and provide soothing relief.
Take a few moments in your day to practice deep breathing, meditation and muscle relaxation activities such as stretching – all of which can reduce stress levels.

Coping and support

Thoracic outlet syndrome can be an incredibly difficult condition to diagnose due to the sheer number of other conditions that can produce similar symptoms. Many people who suffer from this disorder suffer for years before being correctly diagnosed, a situation which can be horribly frustrating and distressing. To ensure that you aren’t subjected to such a lengthy diagnosis period, it is important to make your doctor aware by discussing your symptoms and the issues they are causing. Despite the difficulties involved in diagnosing TOS, there is help available when you ask for it and it’s important that you don’t accept your discomfort as normal or something that you’ll just have to live with – get expert medical help if what you’re experiencing doesn’t feel right!

Preparing for your appointment

To initiate your treatment, you’ll first want to schedule a meeting with your primary care physician. When necessary, they will suggest that you visit a specialist who is skilled in vascular conditions or surgery.

Get ready for your appointment now with this useful information!

Be aware of any pre-appointment restrictions. Going to the doctor’s office can be a hassle, but you can make it much easier on yourself by taking a few simple precautions. Before booking an appointment, ask whether there are any pre-appointment restrictions, such as fasting or abstaining from certain medications. Some clinics and hospitals might also have more specific instructions depending on the procedure being performed. It is important to follow these instructions to ensure you get the most accurate results during your visit. That way, you can get in and out of your appointment in no time so you can go back to focusing on the rest of your day – stress free!
Write down any symptoms you’re experiencing, including any that seem unrelated to the reason for which you scheduled the appointment. Be as specific and detailed as possible in describing your symptoms, including what part of your body is affected and how the discomfort makes you feel. With TOS, there are often symptoms that do not seem like they could be related to neck and shoulder pain. You may experience ear aches or headaches from TOS so be sure to list any ongoing symptoms from all over your body.
Keeping a full and detailed medical record for your doctor to review is essential for staying on top of your health. Make sure you include details about any physical traumas you’ve experienced like car accidents, work-related injuries, or sports injuries. Even if some of these happened years ago, they can still have an effect on your current health and well-being so it’s important to provide all the information you can. It’s also valuable to your doctor to know about any repetitive physical activity you now do or did in the past. This could be from things like working out, playing sports, hobbies, and activities like gardening – anything where you are physically exerting yourself repeatedly that could give clues into how to best care for your body today.
List your key medical information. It’s always important to have an up-to-date list of your key medical information on hand. Such a list should include any other conditions you’re dealing with, as well as the names and dosages of all prescription and over-the-counter medications or supplements that you’re taking. Keeping track of medications and supplements can be especially important if you’re seeing multiple doctors throughout the year, as it can ensure that no one prescribed something that could interfere with another medication you are already taking. Creating this list doesn’t have to be intimidating; document anything you can remember, and your doctor should be able to fill in any gaps – it’s good to stay on top of this!
Take a family member or friend along. Going to a doctor’s appointment can be intimidating, but it’s always helpful to have someone you trust with you. Bringing along a friend or family member is beneficial in ways you may not think of. They can remember things that might slip your mind during the visit, take notes if needed, and show support as well. When it comes to the diagnosis of TOS, having that extra set of ears can only work in your favor. Your companion may even hear something new that could be crucial – one more proactive step towards understanding your medical situation better.
Write down any questions to ask your doctor or surgeon.

Developing a list of queries prior to your appointment with the doctor will ensure that you can maximize your time there and get all the answers. For example, regarding thoracic outlet syndrome, here are some essential questions you may want to ask:

What might be the root of my symptoms?
What kinds of testing will I require?
What therapies are available, and which one do you suggest would be best for me?
To what extent can I expect my symptoms to improve with non-surgical treatments?
If traditional treatments fail to work, is surgery a potential solution?
Can I take any steps to prevent this problem from recurring?
Will I need to transition into a new job to protect my TOS from getting more advanced?
Should I restrict or forgo activities that may be contributing to my symptoms?
Would you suggest I lose weight to alleviate my symptoms? If so, how much weight loss do you think would be necessary for me to see an improvement?
Are there strategies I can use to optimally manage my other health conditions when taking into account this specific one?
May I have a few brochures or other printed material to take home with me? Are there any websites that you recommend I visit for further information?
If I require surgery, do you feel it would be successful?
Will there be permanent damage to nerves or arteries if I choose to not have surgery?

What to expect from your doctor

To gain a better understanding of your health, your doctor may ask about:

At what point did you begin to experience any indications of your issue?
What type of symptoms have you been experiencing?
Has the severity of your symptoms evolved over time?
What area of your body is most affected by pain, and does it spread to other areas?
When you raise your arms above your head, does the pain or numbness intensify?
Are there any other treatments that make your symptoms better or worse?
What tasks are you responsible for in your current role at work?
Are you an avid sports enthusiast or was one in the past?
What do you enjoy doing in your free time? What are some of the activities that bring you joy and relaxation?
Have you received any other medical diagnosis or care in the past? If so, when was that?
Have you observed a diminished color or blue hue in one of your fingers, the whole hand area, and/or any modifications to that region?

What you can do while waiting to see the surgeon

Trying to get a doctor’s appointment can be daunting, but for now you can take steps to relieve your discomfort. If you have pain, an over-the-counter NSAID like ibuprofen may help. Additionally, make sure you stay mindful of your posture and movements – avoid doing the same activity over and over, or lifting anything too heavy. These steps may not resolve the issue entirely, but they should get you comfortable until you can get into see a doctor.

Conclusion

Thoracic outlet syndrome can be a painful and disabling condition. It’s important to take the time to seek out proper medical attention and get properly diagnosed, as this can help you find relief from your discomfort. With the right questions and some preparation, you will have the best chance of getting an accurate diagnosis and treatment plan that works for you. Be sure to take care of yourself in the meantime and stay mindful of your movements and posture. With a little bit of self-care, you should be able to manage your TOS until you can get into see a surgeon.