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Thoracic Outlet Syndrome (TOS) is a condition that can occur in any age group. It typically arises from chronic, repetitive trauma superimposed on an underlying anatomical predisposition. While soft tissue abnormalities account for approximately 70% of cases, bone abnormalities are the causal factor in 30%.
Factors contributing to TOS include:
1. Anatomical Predispositions: These may include congenital developmental defects, an extra rib such as a cervical rib, or abnormally tight fibrous bands connecting the spine to a rib.
2. Poor Posture: Incorrect postural habits, such as slumped shoulders or a forward head posture, can lead to compression in the thoracic outlet region.
3. Trauma: Sudden and severe traumatic events, such as car accidents, can cause internal tissue changes that compress the nerves in the thoracic outlet.
4. Repetitive Activities: Continuous repetition of specific movements can lead to tissue wear and tear over time. Repetitive occupational or daily activities like computer use or raising arms above head level (e.g., placing items on high shelves) can trigger TOS. Athletes such as baseball pitchers and swimmers may develop TOS due to years of repetitive movements.
5. Obesity and Carrying Excessive Loads: Excess weight, heavy backpacks, or heavy bags carried on the shoulder can contribute to compression in the thoracic outlet region.
6. Pregnancy: Ligamentous laxity during pregnancy can cause TOS symptoms to appear for the first time or worsen existing symptoms during this period.
7. Tumoral Lesions: Tumors developing in the upper part of the lung or the axillary region can similarly compress structures in the thoracic outlet, leading to the syndrome.
What causes Thoracic (Outlet) Outlet Syndrome?
Factors contributing to TOS include:
1. Anatomical Predispositions: These may include congenital developmental defects, an extra rib such as a cervical rib, or abnormally tight fibrous bands connecting the spine to a rib.
2. Poor Posture: Incorrect postural habits, such as slumped shoulders or a forward head posture, can lead to compression in the thoracic outlet region.
3. Trauma: Sudden and severe traumatic events, such as car accidents, can cause internal tissue changes that compress the nerves in the thoracic outlet.
4. Repetitive Activities: Continuous repetition of specific movements can lead to tissue wear and tear over time. Repetitive occupational or daily activities like computer use or raising arms above head level (e.g., placing items on high shelves) can trigger TOS. Athletes such as baseball pitchers and swimmers may develop TOS due to years of repetitive movements.
5. Obesity and Carrying Excessive Loads: Excess weight, heavy backpacks, or heavy bags carried on the shoulder can contribute to compression in the thoracic outlet region.
6. Pregnancy: Ligamentous laxity during pregnancy can cause TOS symptoms to appear for the first time or worsen existing symptoms during this period.
7. Tumoral Lesions: Tumors developing in the upper part of the lung or the axillary region can similarly compress structures in the thoracic outlet, leading to the syndrome.