Thoracic Gorge Syndrome

What is thoracic gorge syndrome?

Thoracic Gorge Syndrome is a pathology that occurs due to compression of the neurovascular structures (blood vessels or nerves) located in the thoracic opening, which is the space between the clavicle and the first rib. This disorder most often affects women and is usually common in young adult patients between the ages of 20 and 40.

There are three types of thoracic gorge syndrome:

  • Neurogenic (neurogenic) thoracic gorge syndrome: this is the most common type and is characterized by compression of the brachial plexus.
  • Vascular thoracic gorge syndrome: occurs when the veins or arteries below the clavicle are compressed.
  • Thoracic gorge syndrome of a non-specific type: it generates chronic pain that worsens with activity. However, there is no specific cause of the pain.

Prognosis of the disease

When symptoms are not treated early, the lesions may progressively worsen, so that they can only be treated by surgery. However, specialists recommend surgery when other treatments have not been effective, because surgery presents more risks than other treatments.

Symptoms of thoracic gorge syndrome

The symptoms of thoracic outlet syndrome can vary depending on the structure that has been compressed.

When the compression affects the nerves, symptoms include:

  • Muscle wasting in the thumb
  • Tingling in the arm and fingers
  • Pain in the neck, shoulder and hand
  • Tenderness when grasping

When compression affects the blood vessels, symptoms may include:

  • Swelling in the arm
  • Formation of blood clots in the veins or arteries
  • Appearance of a bluish color in the hand
  • Paleness of the fingers
  • Weak pulse
  • Cold arms, hands, and fingers
  • Tingling in the fingers
  • Weakness in the arm
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Medical tests for thoracic gorge syndrome

Diagnosis of this disorder can be complicated, because symptoms may vary from person to person. In any case, your health care provider should review your symptoms, medical history, and perform a physical examination.

A number of tests may be necessary to diagnose thoracic outlet syndrome:

  • Stimulation tests
  • Imaging tests: radiography, ultrasound, computed tomography, magnetic resonance imaging, angiography, arteriography and venography, and electromyography.

What are the causes of thoracic gorge syndrome?

The main cause of thoracic gorge syndrome is compression of the neurovascular structures, but these structures are compressed for different reasons:

  • Bad posture
  • Trauma
  • Anatomical problems
  • Repetitive activities
  • Pregnancy
  • Pressure on joints

Can it be prevented?

It is important to follow a series of recommendations to prevent thoracic gorge syndrome:

  • Lose weight and maintain a healthy weight if the person is overweight.
  • Avoid carrying heavy objects if you are susceptible to this syndrome.
  • Perform exercises to improve muscle strength
  • Practice relaxation exercises
  • Maintaining good posture

Treatments for thoracic outlet syndrome

When diagnosed early, conservative treatment can be effective. This type of treatment may include:

  • Physiotherapy to relieve pressure
  • Anti-inflammatory or anticoagulant medications.

When conservative treatments have not been effective and the problem persists, surgery may be an option. However, surgery for thoracic outlet syndrome also presents risks and does not always alleviate symptoms. The surgery to treat this pathology is thoracic outlet decompression surgery.

Which specialist treats it?

The physician in charge of treating thoracic outlet syndrome is the specialist in Angiology and Vascular Surgery.