Vulvodynia

Vulvodynia / Pudendal Neuralgia

Thoracic outlet syndrome is a complex condition. It arises from compression of the arteries, veins and/or nerves in the upper chest that lead from the first rib to the collar bone (clavicle), which supply nerve function and circulation to the arm. This anatomic region is a crowded space. When these structures are squeezed, the result can be inadequate blood flow to and from the hand and arm.

Pain, numbness, tingling, or muscular weakness and wasting (atrophy) from nerve damage are also common complaints. Decreased circulation results in a bluish discoloration of the hand or arm, and breakdown of the skin (ulceration) of the fingertips.

Because this disease has many components, including musculoskeletal, vascular and neurological aspects, a definitive diagnosis of thoracic outlet syndrome is difficult. The cause of the disorder may also be difficult to establish. Poor muscle tone and drooping of the shoulder can contribute to the problem, as can abnormalities of the muscles or the first rib.

The treatment plan for thoracic outlet syndrome depends upon many factors, such as the severity of the disease, dysfunction and pain, the type and location of the pain, as well as patient’s age, ongoing medical conditions and ability to tolerate other medical therapies. The doctor will take all of these factors into consideration when prescribing a treatment plan.

Thoracic outlet syndrome is usually treated with medications to reduce pain and physical rehabilitation to maintain muscle strength. In some cases, surgery to remove the first rib may be required to improve function. Neuromodulation techniques, including neurostimulation, may be used to treat unresolved neuropathic pain.