If you experience numbness or tingling in your arms when you raise them, it could be a sign of Thoracic Outlet Syndrome, which occurs when the nerves and blood vessels in the thoracic outlet are compressed.
This numbness can be caused my many things with some being more serious than others.
Mild causes could be due to poor sleeping positions and postures throughout your days.
More serious causes could be due to carpal tunnel syndrome or thoracic outlet syndrome. Thoracic outlet syndrome is a condition that presents with complaints of arm tingling, numbness, weakness and pain. This type of syndrome includes disorders of nerve and blood vessels that are partially blocked off under your collar bone or scalene muscles, which is also called your thoracic outlet.
When the thoracic outlet is compressed, it can block off an important blood vessel that supplies your arms and fingers. This can cause initial discomfort or pain and numbess or tingling. Additionally, the movement of lifting an arm above your head can also cause a pinched nerve in the thoracic outlet. This is where the arm numbness and other signs such as pain and tension in the muscles present.
Some activities that might cause this discomfort or pain are:
There are multiple ways to fix thoracic outlet syndrome. One of the best forms is with physical therapy. A Physiotherapist can give you exercises to help relieve symptoms and give you other treatment options including manual therapy as well as lifestyle modifications such as postural changes to help you after assessing you to find the underlying cause of your symptoms and condition.
In rare cases, your doctor or orthopaedic surgeons might recommend surgery to relieve the pressure, numbness or tingling when you are experiencing extreme amounts of pain or arm numbness. These feelings could be due to nerve damage or blood clots that occur from compression of blood vessels. The goal would be to prevent any more serious complications such as blood clots or a heart attack.
The thoracic outlet is an important bundle of the shoulder, right under the clavicle and the first rib and scalene muscles as the neck meets the chest. It holds many blood vessels and nerves that feed to your arm, hand and fingers. The brachial plexus is an important set of sensory nerves that attaches to the spinal cord and connects to the arms, hands and fingers that is found in the thoracic outlet. These nerves collect sensory information from the skin and can let your brain know when your arm feels pain. These nerve also help you make arm movements, such as lifting your arm to reach a top shelf or to write your name using a pen.
Many things can cause an injury in this area, such as poor posture, repeated motions or trauma. These can cause the nerves and blood vessels to be compressed and only be able to pass through a narrow passageway. As the space in the bundle becomes smaller and smaller, arm pain and numbness or tingling may occur since there is not an adequate blood flow or a nerve is being pinched.
There are three types of thoracic outlet syndromes, with each their own symptoms and causes.
Neurogenic Thoracic Outlet SYndrome is the compression of the nerves, and is the most common type. It is most often presented with pain, and tingling of the arm, hands or fingers. In most cases, neck pain and headaches are common symptoms.
Venous Thoracic Outlet Syndrome is the compression of the main vein, and it most often associated with discoloration to the arm with heavy swelling. Your arm and hand will feel heavy and ache, and may look bluish. This is also known as Paget-Schetter disease.
Arterial Thoracic Outlet Syndrome is the compression of the main artery. It presents with coldness, whiteness of the tips of the fingers or discoloration of the hand. There is usually pain in the hand while performing certain activities.
There are many different types of TOS symptoms around the shoulder depending on the type of syndrome you have. Thoracic outlet syndrome might look like:
Since there are three different types of Thoracic Outlet Syndrome, there are also several potential causes for this disorder.
Some potential causes of Thoracic Outlet Syndrome are genetic such as having a narrower opening under the clavicle, poor spine alignment, having an extra rib, experiencing a heart attack, having blood clots or being overweight. All of these genetic causes would create less space for the brachial plexus which may cause a pinched nerve or decreased blood flow to the arm, shoulders or hands.
Other potential causes are more activity based. These activities are most often repeated movements of the arm and shoulders that could affect the blood flow of the subclavian artery or other important blood vessels or nerves. Having an injury occur to a muscle or soft tissue or joints in the shoulder or neck, poor posture or spine alignment functionally in the body could also contribute to thoracic outlet syndrome.
Here are some functional causes of Thoracic Outlet Syndrome:
It is also important to know the risk factors of Thoracic Outlet Syndrome. Women are far more likely to be diagnosed with the syndrome than are males. Additionally, it mostly affects younger adults between the ages of 20 to 40 years old.
There are two ways to treat Thoracic Outlet Syndrome.
In most cases, your Physiotherapist can treat Thoracic Outlet Syndrome in just a couple of sessions. They will usually perform stretches that will help decrease your symptoms. Your Physiotherapist may also apply pressure to certain areas to help mobilize the nerves in your shoulder. Hor she might also use manual therapy around your collar bone or first rib. They will also prescribe you certain exercises to help relax your muscles. They will also help you improve your posture as this can be one of the main reasons you have symptoms, including tingling or pain. Having good posture will improve mobility and decrease symptoms such as tingling and pain reasonably quickly.
Other times, your doctor might prescribe medications, to help with the discomfort. Medications they might recommend are blood thinners as it makes it easier for the blood to pass thought the veins are arteries, causing fewer symptoms. They will also provide medical advice for your next steps in your treatment plan, based on your diagnosis. One thing that is usually a last resort, but may be recommended by your doctor is surgery.
Another, more uncommon way, to treat Thoracic Outlet Syndrome is surgically. This form of treatment is only used as a last resort by doctors when severe symptoms are present or doctors feel there is a risk of a serious complication such as a heart attack. Surgery may be considered when Physical Therapy or manual therapy is not working. Surgical intervention might mean cutting out a small section of the neck and first rib to allow a wider passage for any nerve or blood vessel around shoulder muscles and neck muscle and fibers.
