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Thoracic Outlet Syndrome Surgeon, Los Angeles

Decompression Surgery for Thoracic Outlet Syndrome (TOS)

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Decompression Surgery for Thoracic Outlet Syndrome (TOS)

At Southern California Multi-Specialty Center (SCMSC), we understand how thoracic outlet syndrome (TOS) can disrupt your life. Pain, numbness, or weakness in your arm, shoulder, or neck can make everyday tasks feel overwhelming. Our team, led by thoracic outlet syndrome specialist and vascular surgeon Dr. Sammy Eghbalieh, offers comprehensive care in Los Angeles. With minimally invasive TOS surgery and collaborative approaches, we help you reduce pain and get back to what you love. Let’s explore how we can support you.

Man experiencing pain from symptoms of Thoracic outlet syndrome

What is Thoracic Outlet Syndrome?

Thoracic outlet syndrome happens when nerves or blood vessels in the thoracic outlet—the tight space between your collarbone and first rib—get compressed. This upper chest area, near the lower neck, houses the brachial plexus nerves, subclavian artery, and compressed vein, which can cause thoracic outlet syndrome symptoms like arm pain, tingling, or swelling.

TOS comes in three forms: neurogenic TOS (nerve-related), venous TOS (vein-related), and arterial TOS (artery-related). Each type needs a tailored approach to avoid permanent nerve damage or blood clots.

Conditions like a cervical rib, poor posture, or scar tissue from injury can trigger TOS. Even lifting heavy objects or playing sports can contribute. At SCMSC, we’re here to pinpoint the cause and ease your discomfort with expert care.

Common Symptoms of Thoracic Outlet Syndrome

Thoracic outlet syndrome symptoms vary, but you might notice:

  • Pain or aching in your neck, shoulder, or dominant arm.
  • Numbness or tingling in your fingers or hand.
  • Weakness when gripping or lifting.
  • Swelling or discoloration in your arm from a compressed vein.
  • Coldness or fatigue in your upper body, especially with arterial TOS.

These signs can mimic spine problems, like a herniated disc, which is why accurate diagnosis is key. If symptoms persist, our thoracic surgeons are ready to help you find relief.

Closeup image of an ultrasound machine

How We Diagnose Thoracic Outlet Syndrome

To diagnose thoracic outlet syndrome, we start with a thorough physical examination and medical history review. Dr. Sammy Eghbalieh listens to your symptoms—whether it’s arm pain in Los Angeles or weakness—and checks for signs like poor posture or scalene muscle tightness. A physical exam might include moving your arm to see if pulses weaken, hinting at blood vessel compression.

We may use tests like a CT scan, ultrasound, or nerve conduction studies to confirm neurogenic TOS, venous TOS, or arterial TOS. If a cervical rib or extra rib shows up, we’ll plan accordingly. Our goal? Get you answers fast so treatment can begin.

Treatment Options for Thoracic Outlet Syndrome

Thoracic outlet syndrome treated at SCMSC starts with your needs. We explore every option to reduce pain and restore function, from conservative treatments to surgical approaches.

Non-Surgical Treatments

Many patients find relief without surgery, especially with neurogenic TOS. Our physical therapists guide you through exercises to strengthen muscles surrounding the thoracic outlet and improve posture. Physical therapy can provide temporary pain relief and prevent symptoms from worsening. Pain medications or a nerve block with local anesthetic, like botulinum toxin type A, may calm nerve pain. Weight loss or avoiding heavy objects can also help if repetitive strain is a factor.

These non-surgical alternatives work for most patients with mild cases. If symptoms linger, we’ll discuss other treatments to keep you comfortable.

Minimally Invasive TOS Surgery

When conservative treatments aren’t enough—say, for venous TOS with blood clots or arterial TOS with circulation issues—surgery may be the answer. At SCMSC, we specialize in minimally invasive TOS surgery, like thoracic outlet decompression, first rib resection, or cervical rib surgery. Dr. Eghbalieh uses small incisions and robotic technology to involve removing the first rib or scalene muscles, easing pressure on the brachial plexus or subclavian artery.

Compared to traditional invasive treatment with larger cuts, our approach means less pain, reduced risk of scar tissue, and a faster recovery time—often weeks, not months. General anesthesia keeps you comfortable, and our precision lowers chances of blood clots or permanent nerve damage.

Collaboration for Complex TOS Cases

TOS can overlap with spine issues, like a cervical rib pressing on nerves, which is why our collaborative care stands out. Dr. Sammy Eghbalieh, a leader in vascular surgery, teams up with neurosurgeons or orthopedic specialists for cases needing spine exposure surgery. This teamwork ensures we address both vascular and spinal concerns, like blood vessel compression or nerve pain, in one go.

Why does this matter? Spine surgeries near the upper chest can risk TOS symptoms—estimated at under 5% for most cervical procedures, but up to 10-20% if a cervical rib’s involved. Our collaborative approach, detailed in our blog on collaborative spine exposure surgery, lowers that risk to 1-3% by protecting blood vessels and nerves with minimally invasive techniques. Dr. Eghbalieh’s expertise makes SCMSC a trusted name for thoracic outlet syndrome surgeons.

Practical Tips for Managing TOS Symptoms

While you plan treatment, try these at-home tips to ease thoracic outlet syndrome symptoms:

  • Practice good posture to open the upper chest area, reducing nerve pressure.
  • Avoid carrying heavy objects on your shoulder to prevent strain.
  • Stretch gently with a physical therapist’s guidance to relax scalene muscles.
  • Use a supportive pillow to align your lower neck during sleep.
  • Limit repetitive arm motions, like those in sports, to avoid worsening pain.

These can provide temporary pain relief until we tailor a plan. Check with us before starting stretches to stay safe.

Why Choose SCMSC for TOS Treatment?

SCMSC is a top choice for thoracic outlet syndrome treatment near me, thanks to our expertise and care. Dr. Sammy Eghbalieh, with thousands of vascular surgeries, leads our team of thoracic surgeons. Our Los Angeles facility offers advanced imaging, like CT scans, and minimally invasive techniques for first rib resection or decompression surgery. We treat similar symptoms, like neck conditions, with a holistic approach, ensuring your recovery is smooth.

Our collaborative care, blending vascular and spine expertise, sets us apart. Whether it’s neurogenic TOS or venous TOS, we’re here to deliver results with less pain and faster healing.

Thoracic Outlet Syndrome Q & A

Labeled illustration of Thoracic Outlet Syndrome

Arm, neck or should pain can be signs of Thoracic Outlet Syndrome (TOS).

What Raises My Risk for Thoracic Outlet Syndrome?

Certain factors make developing thoracic outlet syndrome more likely. Women, especially those aged 20-50, face higher odds due to anatomy. Athletes or former athletes, particularly in sports like swimming or baseball, may develop TOS from repetitive arm motions. Poor posture, like slouching at a desk, can tighten the upper chest area. An extra rib, called a cervical rib, or anatomical quirks like tight scalene muscles play a role too. Injuries, pregnancy, weightlifting, or even rare tumors can also contribute. At SCMSC, we assess your risk factors during a physical exam to tailor your care.

Can Thoracic Outlet Syndrome Come Back After Surgery?

While surgery, like first rib resection, is effective, there’s a small chance—about 15-20% for neurogenic TOS—that symptoms could return, often due to scar tissue or incomplete decompression. Our minimally invasive TOS surgery at SCMSC lowers this risk by using precise techniques to clear the thoracic outlet fully. Dr. Eghbalieh’s collaborative approach further reduces recurrence by addressing vascular and spinal issues together. If symptoms creep back, we’re here with physical therapy or other treatments to keep you comfortable.

How Long Does It Take to Diagnose TOS?

Diagnosing thoracic outlet syndrome can take a few weeks, depending on your symptoms and tests. We start with a medical history and physical exam, checking for nerve or blood vessel compression. Tests like a CT scan or ultrasound might follow, typically within days if needed. Complex cases, like arterial TOS, may need extra steps, but we aim to confirm TOS quickly—often in 1-3 visits—so you can start treatment fast. Call us to get the process moving.

Treatment Options for Thoracic Outlet Syndrome

If thoracic outlet syndrome is left untreated you could be at risk for permanent arm pain and/or swelling, gangrene, pulmonary embolism, or permanent nerve damage. The goal of treatment for thoracic outlet syndrome is to manage pain through decompression surgery.

Early diagnosis can help improve treatment outcomes. Most patients with thoracic outlet syndrome are treated with physical therapy or medical management with pain medications, thrombolytics, or anticoagulants. About 10-20% of patients with thoracic outlet syndrome will need surgical intervention.

To schedule an evaluation with Dr. Eghbalieh or his team of vascular surgeons at Southern California Multi-Specialty Center, call 818-900-6480.

Why Choose SCMSC for TOS Treatment?

SCMSC is a top choice for thoracic outlet syndrome treatment near me, thanks to our expertise and care. Dr. Sammy Eghbalieh, with thousands of vascular surgeries, leads our team of expert surgeons. Our Los Angeles facility offers advanced imaging and minimally invasive techniques for first rib resection or decompression surgery.

Our collaborative care, blending vascular and spine expertise, sets us apart. Whether it’s neurogenic TOS or venous TOS, we’re here to deliver results with less pain and faster healing.

Our Vascular & Endovascular Surgeons

It's important to remember not all physicians are trained in advanced vascular and endovascular surgery. It’s a good practice to get multiple opinions and do research on the surgery and the physician.

Dr. Sammy Eghbalieh is the best vascular surgeon in Los Angeles at the Southern California Multi-Specialty Center

Sammy Eghbalieh, MD, FACS, FSVS, RPVI

Dr. Andrew Abi-Chaker is a top vascular surgeon at Southern California Multi-Specialty Center in Los Angeles
Andrew Abi-Chaker, MD
Dr. Sammy Eghbalieh is the best vascular surgeon in Los Angeles at the Southern California Multi-Specialty Center
Tony Shao, MD, RPVI
Dong H Lee, MD, FACS of SCMSC
Dong H Lee, MD, FACS

Decide with Confidence

Expert Second Opinions at SCMSC

two surgeons discussing CT imaging for second opinion
SCMSC offers thorough second opinions from our team of specialists who often identify less invasive treatment options overlooked by others. Our collaborative approach brings multiple surgical perspectives to your case—something rarely found in traditional hospital settings.

Many patients discover alternatives to major surgery or more precise treatment approaches after consulting with our experts. Whether you’re facing a new diagnosis or considering surgery, our team provides clarity and confidence in your healthcare decisions.

Learn more about our unique second opinion process or call (818) 900-6480 to schedule a free 15-minute consultation with our Care Coordinator.

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