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.
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.
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
Arm, neck or should pain can be signs of Thoracic Outlet Syndrome (TOS).
What Raises My Risk for Thoracic Outlet Syndrome?
Can Thoracic Outlet Syndrome Come Back After Surgery?
How Long Does It Take to Diagnose TOS?
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?
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.
Sammy Eghbalieh, MD, FACS, FSVS, RPVI
