![]() These types of injuries commonly occur during automobile or motorcycle accidents, falling onto an outstretched arm, or anything that forcefully pulls on or causes the arm to be stretched. Any type of injury mechanism which causes rapid widening of the angle between the neck and shoulder, whiplash-type injuries to the neck, blunt trauma to the base of the neck/collar bone area, or traction to the arm can lead to neurogenic TOS. Neurogenic TOS is most commonly arises following some type of trauma. Use of the arm can result in rapid fatigue of the muscles or claudication which is pain similar to a muscle cramp. The arm and hand may appear pale and be cold to the touch. Venous TOS typically presents with abrupt, spontaneous swelling of the entire arm along with pain, heaviness, and a bluish discoloration of the arm.Īrterial TOS usually presents with a sudden onset of pain and weakness in the affected arm, along with numbness or tingling of the hand and fingers. ![]() All these symptoms of neurogenic TOS tend to be made worse with any type of repetitive or prolonged use of the affected arm, especially activities requiring the arm to be extended above the patient’s head. Patients can experience pain over the upper back or shoulder blade posteriorly, as well as chest or breast pain anteriorly. Neurogenic TOS can produce “headache” pain on the affected side, facial pain, jaw pain, and ear pain. This is pain that usually starts in the posterior neck area and then radiates down between the spine and the border of the shoulder blade. Parascapular pain is another common feature of neurogenic TOS. ![]() Patients with neurogenic TOS tend to avoid carrying anything heavy, either held in the hand or requiring a strap over the affected shoulder, like a purse or backpack. There if usually some degree of weakness in the affected extremity and patient’s often report that their arm feels “heavy” or that it will fatigue very quickly with repetitive use. Common symptoms are pain, numbness, tingling, and pins/needles sensation. Neurogenic TOS can produce an astonishing variety of different clinical symptoms and signs potentially affecting many different areas including the head, neck, upper back, shoulder girdle, chest, arm and hand. The symptoms associated with TOS depend on which structures are being compressed. ![]()
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