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Thoracic outlet syndrome

Thoracic outlet syndrome (TOS) is a syndrome involving compression at the superior thoracic outlet wherein excess pressure placed on a neurovascular bundle passing between the anterior scalene and middle scalene muscles. It can affect one or more of the nerves that innervate the upper limb and/or blood vessels as they pass between the chest and upper extremity; specifically in the brachial plexus, the subclavian artery, and - rarely - the subclavian vein, which does not normally pass through the scalene hiatus.

Source: Wikipedia

What are the symptoms?

Within all the people who go to their doctor with thoracic outlet syndrome, 68% report having arm pain, 68% report having neck pain, and 54% report having shoulder pain. The symptoms that are highly suggestive of thoracic outlet syndrome are arm pain, paresthesia, hand or finger weakness, and shoulder weakness, although you may still have thoracic outlet syndrome without those symptoms.


What might my doctor prescribe?

Common Tests and Procedures

Patients with thoracic outlet syndrome often receive physical therapy exercises, other diagnostic procedures (interview; evaluation; consultation), other physical therapy and rehabilitation, magnetic resonance imaging, other therapeutic procedures, thyroidectomy; partial or complete, cardiac stress tests and orthopedic casting .

Common Medications

The most commonly prescribed drugs for patients with thoracic outlet syndrome include gabapentin, pregabalin (lyrica), acetaminophen / diphenhydramine, glatiramer (copaxone), acetaminophen / aspirin / caffeine, codeine, letrozole (femara), pyridoxine, leuprolide (lupron), metaxalone (skelaxin) and terazosin .

Gabapentin
$25
(28 days)
Pregabalin (Lyrica)
$148
(28 days)
Glatiramer (Copaxone)
$2857
(28 days)
Codeine
$46
(21 days)
Letrozole (Femara)
$394
(28 days)
Pyridoxine

Leuprolide (Lupron)
$961
(28 days)
Metaxalone (Skelaxin)
$223
(28 days)
Terazosin
$8
(28 days)

Who is at risk?

Groups of people at highest risk for thoracic outlet syndrome include sex == male age 45-59 years.

Age

< 1 years
1.1x
1-4 years
0.6x
5-14 years
0.2x
15-29 years
0.5x
30-44 years
1.3x
45-59 years
1.9x
60-74 years
1.1x
75+ years
0.4x

Sex

Male
1.6x
Female
0.6x

Race/Ethnicity

Black
0.5x
Hispanic
1.0x
White
1.2x
Other
1.0x
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