Thoracic Outlet Syndrome

///Thoracic Outlet Syndrome

Pain, weakness and numbness in the shoulder, arm and hand may be associated with a shoulder nerve entrapment syndrome. Two common nerve conditions that affect the shoulder joint and cause discomfort are thoracic outlet syndrome and a suprascapular nerve injury. The main cause of thoracic outlet syndrome is when nerves and blood vessels traveling to the arm and hand get squeezed near the thoracic outlet, the space between the collarbone and first rib. A suprascapular nerve injury may occur during a shoulder dislocation, fracture or labral tear. Shoulder specialist proudly serving the Long Island, Brooklyn, Queens and NYC area, Dr. Jonathan Ticker is available to assist patients suffering from a nerve injury within the shoulder joint.

Patients experiencing shoulder pain and other troublesome symptoms may be suffering from a shoulder nerve entrapment syndrome. The two most common conditions include:

  • Thoracic outlet syndrome- This nerve condition places pressure on the nerves and blood vessels near the thoracic outlet. The thoracic outlet is defined as the space between the collarbone and first rib. This pressure is commonly caused by a clavicle fracture or in people with an extra first rib.
  • Suprascapular nerve injury- The suprascapular nerve originates from the superior trunk of the brachial plexus and provides both motor and sensory sensations to the muscles within the rotator cuff. An injury to this particular nerve can occur from a labral tear, fracture or dislocation to the shoulder joint. This condition is also commonly found in athletes who perform repetitive overhead arm movements.

Symptoms of Thoracic Outlet Syndrome and a Suprascapular Nerve Injury

Both a suprascapular nerve injury and thoracic outlet syndrome cause shoulder pain, weakness and numbness. Pain associated with thoracic outlet syndrome most often occurs along the top of the shoulder and clavicle. Muscle wasting, swelling, difficulty performing overhead activities and pressure on the shoulder’s nerves and blood vessels are also common.

Diagnosis of Thoracic Outlet Syndrome and a Suprascapular Nerve Injury

Dr. Ticker will diagnose the proper shoulder nerve entrapment syndrome after a complete medical review and physical examination. In most patients, he also performs imaging tests, such as x-rays, an MRI scan or a CT scan, to better see and evaluate the affected bones, tendons, muscles and blood vessels.

Treatment of Thoracic Outlet Syndrome and a Suprascapular Nerve Injury

Non-Surgical

Both thoracic outlet syndrome and a suprascapular nerve injury are initially treated with non-surgical measures. Patients are often encouraged to modify activities, rest the affected shoulder, utilize anti-inflammatory medications (NSAIDs) and participate in a thorough physical therapy and rehabilitation program. A physical therapist will develop the appropriate strengthening exercises for the patient’s shoulder nerve entrapment syndrome.

Surgical

If conservative treatment does not alleviate symptoms, Dr. Ticker may recommend a surgical procedure. Surgery for thoracic outlet syndrome may involve removing a portion of an abnormal first rib, releasing a muscle that joins the neck and chest, or sometimes both. In cases of a suprascapular nerve injury, a variety of surgical decompression procedures may be considered by Dr. Ticker.

For additional details on thoracic outlet syndrome or a suprascapular nerve injury, or for more information on treatment for a shoulder nerve entrapment syndrome, please contact the Long Island, Brooklyn, Queens and NYC area orthopedic office of Dr. Jonathan Ticker.

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