This is a label given to a group of disorders. In these disorders, nerves or blood vessels are compressed in the space between your collarbone and the underlying rib. This space is called the “thoracic outlet”.
The first part of the diagnosis is a good patient history and careful physical examination. MRIs and x-rays usually do not show TOS. To help confirm TOS diagnosis, an anesthetic block of the scalene or other pinched muscles may be performed with EMG guidance, which measures electrical activity in muscles. If this procedure temporarily relieves symptoms, it is highly suggestive of TOS. Other causes of arm and hand numbness can be ruled out with an EMG-nerve conduction study. Non-invasive ultrasound vascular studies and surgical consultation may also be performed.
MYOBLOC injections may provide relief by relaxing tight muscles that affect or impinge on the nerves. Patients may experience relief for up to 12-16 weeks. Each patient’s response is unique and it may take a few injections to receive maximum benefit. If your insurance plan covers this procedure, you may need to get pre-authorization. Our staff can help you with this process.
Many patients obtain relief with these treatments and return to most or all normal activities. Injection therapy with MYOBLOC or surgery may be helpful for more severe cases of TOS.
