The symptoms of thoracic outlet syndrome can vary depending on which type of thoracic outlet syndrome you have. And since it is a group of disorders not all symptoms may be present or even constant.
Neurogenic Thoracic Outlet Syndrome
The most common type of thoracic outlet syndrome is Neurogenic Thoracic Outlet Syndrome where the brachial plexus is compressed. By some estimates, 95% of all thoracic outlet syndromes are neurological in nature. Compression of these nerves results in symptoms such as:
- Pain in your neck and shoulders
- An ache throughout your arm
- An ache in your hand
- Numbness, partial loss of sensation or tingling in your fingers
- A weakening in your grip strength
- Gilliatt-Sumner hand, which is when muscles of the hand, particularly around the base of the thumb, atrophy or waste away
Many of the symptoms of the neurogenic thoracic outlet syndrome are similar to other nerve-related repetitive stress injuries where swelling or inflammation presses on the nerve. This can send shooting pains or radiate aching throughout the affected area. Compression of a nerve can also restrict the signals flowing along the nerve resulting in a loss of sensation or tingling.
Since the nerves control the actions of the muscles if the signals are lost or otherwise affected the muscles cannot operate efficiently and you experience weakness. With a prolonged loss of nerve supply, the muscles will atrophy and waste away to be reabsorbed by the body.
Vascular Thoracic Outlet Syndrome
In Vascular Thoracic Outlet Syndrome where either the subclavian artery or the subclavian vein are compressed symptoms are consistent with reduced blood flow such as:
- Pain and possible swelling of the arm
- A loss of color at your extremities (hand and/or fingers)
- A weak pulse in your arm
- A bluish discoloration of your extremities (hand and/or fingers)
- Infarcts, or tiny spots (usually black) on your extremities (hand and/or fingers)
- A throbbing lump near your collarbone
- A blood clot under your collarbone (known as a subclavian thrombosis)
The symptoms of vascular thoracic outlet syndrome are typical complications resulting from reduced blood flow. Low blood supply can show up as pallor or loss of color as well as a weak pulse. This is most likely associated with compression of the subclavian artery on the supply side of things. That compression may also result in a throbbing lump near your color bone a result of an area of higher blood pressure as the nominal blood supply is forced through a smaller opening.
Restriction of the subclavian vein on the return side can lead to a buildup of oxygen-depleted blood resulting in a bluish discoloration. It can also show itself in the form of pain and swelling as the blood pressure increases from a normal supply and a reduced ability to return it to the heart causing a backup of blood in the arm.
Reduced blood flow from either the supply or the return side can increase the chance of a thrombosis or blood clot as well as infarcts.
A loss of blood supply may also contribute to muscle atrophy in some cases but the reduction in vascular thoracic outlet syndrome is not normally considered great enough to cause atrophy without causing other major concerns first.
Non-Specific Thoracic Outlet Syndrome
Non-specific Thoracic Outlet Syndrome is so named because the cause is not clearly identifiable. In these cases, the symptoms of thoracic outlet syndrome may be a combination of both neurogenic and vascular disorders or simply a pain or ache throughout the arms and shoulders or around the upper chest and collarbone.