You will see some articles concerning TOS in my blog. I was clinically diagnosed with TOS or Thoracic Outlet Syndrome on 2006 and the cause of my TOS was 2 Cervical Ribs. Ever since the diagnosis, my life- personal & professional; has changed a lot.

I underwent 2 separate surgeries for the removal of the cervical ribs. The right one was removed in November 2009. Left one was removed in February 2012. Other TOS related articles can be found here.

I was a Dentistry student in 2nd year when I was diagnosed. I finished my studies and completed the degree with my chronic pain & everyday discomfort. I took some time off afterwards so that my body gets the time and opportunity to be healed after the surgeries.

What is a Cervical Rib?

A cervical rib is a supernumerary (or extra) rib which arises from the seventh cervical vertebra. It is a congenital abnormality and located above the normal first rib. A cervical rib is present in only about 1 in 500 (0.2%) of people; in even rarer cases, an individual may have two cervical ribs. Cervical ribs are sometimes known as “neck ribs”.

What is TOS?

TOS stands for Thoracic Outlet Syndrome. The thoracic outlet is the area between the rib cage and collarbone. Thoracic outlet syndrome is a rare condition that involves pain in the neck and shoulder, upper arm, numbness & tingling of the fingers and a weak grip.

What are the symptoms?

1. Pain in the arms and hands is almost ALWAYS present. Pain can also be found in the side of the neck, the area below the clavicle. It can be sharp, burning or aching in nature. It can involve only part of the hand, as in the 4th and 5th finger only, or all of the hand.

2. Weakness of the hand and arm muscles are also common.

3. Tingling can also be present.

P.S.- I had all of the above.

Why does it happen?

– The main reason for occurring TOS is compression of nerves and blood vessels which supply the arms. This compression can be caused by congenital anomaly like “cervical rib” (above the first rib) or an abnormal tight band connecting the spinal vertebra to the rib.

– Patients often have injured the area in the past or overused the shoulder.

What are the TYPES of TOS?

There are mainly 3 types of TOS.

Neurogenic TOS
Arterial TOS
Venous TOS

Neurogenic TOS (nTOS)

-Classic symptoms of nTOS include pain, paresthesias, or weakness in the upper extremity. Paresthesia [ An abnormal sensation often described as burning, tingling, or pin pricks] most commonly affects the ring and small fingers.

-Symptom severity tends to increase after certain activities and worsens at the end of the day or during sleep.

Arterial TOS (aTOS)

-It is mainly caused by congenital bony abnormalities in the lower neck and upper chest.

-Symptoms include cold sensitivity in the hands and fingers; numbness, pain or sores of the fingers; and poor blood circulation to the arms, hands, and fingers.

Venous TOS

-This condition is caused by damage to the major veins in the lower neck and upper chest area. The condition develops suddenly, often after unusual and tiring exercise of the arms.

-Symptoms include swelling of the hands, fingers, and arms, as well as heaviness and weakness of the neck and arms. The veins in the anterior (front) chest wall also may appear dilated (swollen).

Traumatic TOS

-This is another type of TOS which is not caused by birth defects. Traumatic TOS is caused by a traumatic injury or repetitive activities. Check out this article to read about the everyday actions which make the condition worse.

-The symptoms include pain, tenderness; an abnormal prickling, burning sensation that is mostly felt in the hands, arms, legs or feet; sensory loss and weakness. Body postures will make these symptoms worse.

Disputed TOS

-Disputed TOS is highly controversial. Some doctors don’t believe that it even exists, while other doctors feel that it is fairly common. Hence the name Disputed TOS.

-It is believed to be caused by a nerve injury in the brachial plexus. The symptoms of Disputed TOS include pain, weakness and fatigue.

Is it just a mind-game OR the pain is real?

Oh yes it’s real!

Trust my words and other sufferers’ when they say, “Everything is falling apart“, ” I can’t breathe with the pain“, “Painkillers are not working anymore“…. all these are true. Even after surgery (or multiples surgeries), you can’t get rid of the pain. It will be there, more or less, for rest of our lives.

Would you like to look into the life of a TOSer? Then check out some of my fellow TOSers and my everyday experiences here!

So, Is there no cure?

Some people get “relief” by physiotherapy, some get by surgery and for some unfortunate ones, they never get pain free even after surgery.

If you are suffering from Thoracic Outlet Syndrome or any other chronic pain disorder then join this Facebook support group.

I just want you to know that you are not alone!

Sifa’s Corner on,

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