Thoracic Outlet Syndrome Care at UC Davis Medical Center

UC Davis Health has a clinic dedicated to thoracic outlet syndrome. The condition occurs when blood vessels or nerves running from the upper body through the arm become compressed, causing problems ranging from reduced mobility and pain to life- and limb-threatening blood clots. The clinic is led by Dr. Julie Freischlag, an internationally recognized vascular surgeon and former dean of UC Davis School of Medicine.
For more info, visit vascular.ucdav...
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The information in this video was accurate as of the upload date, 2/25/15. For information purposes only. Consult your local medical authority for advice.
#thoracic #thoracicoutletsyndrome

[@soundthealarm]

Just diagnosed with this yesterday. I have been dealing with this for 3.5 years and going to various appointments for a consistent 20 months. Finally an answer!

[@emilycalkins9298]

Thank you, Dr. Humphries and Dr. Freischlag, for giving my sister her life back!

[@cathyleblanc4347]

5+ years with NTOS Symptoms..I have going through 7 doctors ..That didnt listen to my therapist that diagnosed me..I have lost muscle and strength in both hands. Never give up..

[@KimSyracuse-tc9tb]

Do you lose strength in moving pans from the stove to sink and drop the pan of water I was with another doctor but I change the whole doctor and hospital and my doctor said something about my thoracic but sences last thing that happened to me passing out and having seizure at the place I was doctor look at the CT scan and they couldn't find anything about seizure at all so I have to see cardiology doctor now they want to find out what happened to me

[@victoriasalcido2099]

I was diagnosed with Thoracic Outlet Syndrome back in January of this year. It sucks because, every time i see my classmates in my dance class in highschool raise their right arm without any potential issues. Im going to get my first rib removed days after I graduate from high School. After the pre-op appointments with the hematologist and vascular surgeon.

[@bg147]

I had much of my pec minor on my right side removed due to pain. When the doc would pull my arm back, the artery... I believe the axilary artery was compressed against the head of the humerus. Regardless, after some months. there was a release. Today, I have some tension in my other shoulder/upper back as a result of the release and rotation. It isn't a big deal and the original pain on the other side is gone. The thing I dislike is the asymmetry in my upper body as a result of the surgery and release. One thing I never mentioned and nobody ever mentioned was my my scoliosis. My guess is my problem was due to the scoliosis and building up my muscles through weight training.

[@evestherapy]

Medical massage is a great solution.

[@adrianarce4738]

ive never been in an accident, or experienced trauma, but I have been diagnosed to this from being in the gym too much. Really was the worst news of my military career

[@svetlanalukyanov5775]

May I ask how they finally diagnosed you? I have been dealing with pain for 2 years

[@LoyalLady318]

Was hoping you'd mention cervical herniated discs: C 5/6 and C 6/7 swollen supraspinatus and scalene muscles as cause of TOS. Discs dx 9/1997. TOS 2007. Am I unique with my cause of TOS and could I be helped surgically? Lumbar herniations causing worse pain. I was hopeful of Artificial Disc Replacement eventually being done in USA, but unfortunately I'm not in the right socioeconomic niche to be granted anything of the sort. I'd like to have ONE surgery on Degenerative Disc Diseased spine, all herniated discs replaced or whatever old, barbaric, methods still mostly used in USA: fusion, rods, et cetera. One thing to note, I can't take WORSE pain. Thoracic is crunching, popping, clicking and aching, so entire spine being stabilized and strengthened isn't too far out of the realm of necessity. One recuperation period would go optimally. Oddly enough, Connective Tissue, surgical incision and bone wise, I heal quite well and remarkably quickly. "Dream on" I know, but thank you for reading. I exist in East Central PA.

[@alexanderleeart]

wouldn't there be some kind of structural integrity problems associated with removing the rib?

[@belongz2god275]

Alexander Lee not if you were born with EXTRA FIRST CERVICAL RIBS

[@belongz2god275]

Airic which sad to say, I am ONE, and actually even more rare is I have it BILATERAL. Very very painful

[@jessicacook6899]

Hi there. I was diagnosed with thoracic outlet syndrome just recently by a cardiologist in Los Angeles. I’ve had it since I can remember. I don’t mind going to UC Davis to get checked out, but do you recommend a doctor in LA? My left arm turns purple and splotchy when i pull my shoulders back where they should be in seconds and if I raise my left arm for a few seconds, there is no pulse to be found. The cardiologist ended up making me a science display for his nurses and other doctors in the office, so they all came in to feel my “ghost arm”, but I can’t seem to find anyone down here that knows ANYTHING about it. Anyway, I’d love to run some tests and see which type of TOS I have to see if it can be treated, because it hasn’t been the easiest thing to deal with for a very physically active me and I’d love to be able to pull my shoulders back and have good posture. I’d just love some guidance or advice on the matter. :)

[@relationshiplifecoach9440]

OH.... my God! Doctors... I NEED YOU HELP! I HAVE BEEN SUFFERING THIS IS COMFORT FOR 3YRS WITH ZERO HELP! SO MANY DOCS AND NO RESULT. PLEASE PLEASE HELP ME!

[@ginarediger9743]

I had an MRI due to numbness and weakness in my right arm. Had an MRI and found out I have bilateral cervical ribs how likely is it that these "extra" ribs are the cause?

[@memo6x9]

It's very likely 😔

[@ginarediger9743]

@@memo6x9 yes, since this post I found out it was exactly my problem because the rib was compressing my nerve and also an artery when I raised my arms. In 2019 I had my right cervical rib and part of my first rib removed. I felt an IMMEDIATE relief. Today I very occasionally feel the nerve pain when I over do it, but nothing compared to the years before.

[@bgudge89]

I have been trying to contact UC DAVIS as I am from Australia with 3 types of TOS. Four surgeries. 3 surgeries last year and one this year. I am an icu nurse and can’t return to work untill I can handle my work again. Please reply here or if you could supply an email I could write to. I have already emailed but haven’t heard anything back. Please help! I need your help!

[@bobsinclair2026]

i have venous TOS had a dvt in my subclavien vein was treated with thrombolysis and been on xarelto since, does your center use the supraclavicular approach?

[@UCDavisHealth]

Yes, we have used the supraclavicular surgical approach to treat arterial thoracic outlet syndrome when the subclavian artery needs to be replaced or if the patient requires reiteration and the first operation was done transaxillary. Otherwise, we feel the transaxillary approach in our hands is best for neurogenic, venous and arterial TOS, as long as the artery does not need to be replaced. More information is in an article titled “Choosing the Transaxillary or Supraclavicular Approach for Neurogenic TOS” in ACS Surgery News: bit.ly/2jHyvu7

[@bobsinclair2026]

Hello, my thoracic surgeon said supraclavicular approach is optimal for vTOS because: - good access to artery, brachial plexus - better view of all the structures - better for removing scar tissue - excellent for re do - excellent for excising impinging scalene muscles where as the transaxillery approach has the following drawbacks: - risk of damage to the intercostal brachial nerve - neurolysis of upper brachial plexus difficult - incomplete exposure to entire scalene triangle - limited for vascular reconstruction of the vein

[@bradleycass11]

massage therapy does wonders

[@kathymorris4553]

I have a extra rib on each side of the neck, but have only 11 going down. And I had no gallbladder

[@youzad123]

Hi Doctor , please can you help me with this ??, two weeks ago My father had an open heart surgery for coronory bypass,, and now he is doing well in general , but he has some pain in his left shoulder down to his elbow and arm , associated with numbness in his tow fingers,,,, please Dr could this be a case of thoracic outlet syndrome ?? how can we help him in this critical stage of his recovery??? thank you Dr

[@UCDavisHealth]

+youzad123 It is difficult to say whether or not your father’s symptoms could be related to his heart surgery or TOS or something else entirely. We encourage you to talk with his surgeon and bring up your concerns about thoracic outlet syndrome as a possibility. If you’d like your father’s case reviewed by a UC Davis cardiac or vascular surgeon, please call our Consumer Resource Center at 1-800-2-UCDAVIS (1-800-282-3284).

[@izzysat7041]

I find out my from ultrasound by lifting my arm in difference positions and show the uneven pulse, so i did physical therapy with out procedure and loose weight is definitely my symptoms are going away

[@silverfullbuster9177]

How are you know? Are you symptom free

[@mikehlusak1371]

Do you have any recommendations in Minnesota or nearby please?

[@kayesnediker2102]

I'm currently at 4 plus years of symptoms, only worsening drastically over time. Dr. Newkirk has now recommended I see your facility for consult, MRA/MRV/MRI and possible surgery. Can you tell me if your facility accepts work comp? thank you in advance

[@UCDavisHealth]

+Kaye Snediker Yes, we do accept workers' comp patients. You are doing the right thing by working through Dr. Newkirk to finalize your referral to our TOS clinic. We look forward to meeting you.

[@emceep]

Hi, any recommendations for someone in Las Vegas? Or should I go to california?

[@austonpower21]

and surgery is the only option!!!! Geees! before having you cut open, and having stuff remove (which are probably useful) would'nt you rather try either manual therapy for relaxing the scalen muscle, small pectoral and seeing if the mobility of the first rib and clavicule are ok...I mean try chiropractic, physiotherapy whatever works to do what i just said above... And of course they don't talk about the consequences post-surgery...

[@UCDavisHealth]

+austonpower21 We absolutely agree! Most patients with TOS do not require surgery and do very well with physical therapy, exercise therapy, pain therapy and ergonomic changes. Surgery is an option for those whose suffering isn’t relieved by these initial approaches. More detailed info is available on our UC Davis Vascular Center website: www.ucdmc.ucdavis.edu/vascular/diseases/TOS.html.

[@austonpower21]

well that's good to know! for a moment there i thought you plan the surgery as soon as you detect the problem...because there is no mention of manual therapy before surgery in this video! but hey i'm not here to argue, at least you acknowledge the fact...that's good enough for me! have a good day!

[@brodhax6148]

Also at the start of the video they say "Its a rare and complex disorder". Well its not THAT rare. In fact, I would venture to say its fairly common. Theres millions of people who have nerve impingements that lead to arm/hand issues. This video almost felt like a commercial to drum up business. Sensationalized it a bit

[@starfeel6127]

I don't want to remove muscles i need those!

[@lizsimpson3]

Can you talk about the use of anti-coagulant post surgery (rib resection) for people with venous TOC?

[@UCDavisHealth]

+lizsimpson3 Every patient is different, but in general the optimal approach is anticoagulation therapy prior to rib resection, with venography and, if needed, venoplasty following surgery to assure improved blood flow. However, depending on the appearance of the vein during surgery and level of scar tissue, anticoagulation therapy may be recommended for up to six months following surgery.

[@atul4263]

myself atul . i m from INDIA.doctor told me i have cervical rib so that was a reason told me i have TOS. now doctor tell me is there any cure for this .. i m in hell plse help me .is there any tretment?

[@Teqo7]

My mother had the Cervical ribs on both sides. She got them removed in the 90's. I have been feelings numbness in my arms for many years and I think I have the cervical ribs too. :(

[@JerrySeriatos]

Hello, any doctors whom you would recommend in New York City area? I have been in pain for two years. thank you

[@UCDavisHealth]

Dr. Darren Schneider: weillcornell.org/darrenschneider

[@ThanksForWatchingBu]

hello do you treat private international individuals? I am living in Sweden at the moment but coming to California in 8 weeks and suffer many of the symptoms of TOS. My fingers tingle constantly, I have aches in the arms, and I lost strength in my arms. Prior to an accident 14 months ago during which I landed on my head while snowboarding, I was in great health. 7% body fat, could easily bench press 200lbs, weighed 190lbs at 6ft 1inch tall so all in all in great physical shape. Since the accident I first had terrible neck and back pain which with a lot of treatment and therapy went away, but the arm pain came around 1 month after I finished back and neck treatment. Since then I have had EMG and ENeG scans and MRI scans that have shown little to nothing.

[@UCDavisHealth]

+Andrew Smith Please email [e-mail] so we can put you in touch with our clinical team. Thank you.

[@UCDavisHealth]

+Andrew Smith Please email [e-mail] regarding your request.

[@SeriouslyBadElf]

Can you recommend someone in washington DC or maryland?

[@NilaL]

Do you have any recommendations for doctors in either the Florida or Virginia area???

[@UCDavisHealth]

+Nila L Yes, we recommend Karl Illig at USF Health in Tampa or Ying Wei Lum at The Johns Hopkins Hospital in Baltimore.

[@alexanderleeart]

Also, any recommendations for doctors specializing in this in the Los Angeles area?

[@UCDavisHealth]

We recommend David Rigberg or Hugh Gelabert at UCLA.

[@numberuno7532]

UC Davis Health I live in San Diego and Irvine California who would you recommend to see for Neurogenic Tos?

[@alcantaraervin2324]

Hi, me and my physical therapist think I have ntos. I used to weightlift, but now I’m struggling with most activities. I have Kaiser insurance. Is there any way I could be seen at Davis for this?

[@UCDavisHealth]

Hello and thank you for contacting us. Please send a note via email to Herjeet Kumar at [e-mail] to coordinate a referral to our TOS clinic. Take care!

[@alcantaraervin2324]

UC Davis Health thank you for responding!

[@ArcadiyIvanov]

@UC Davis Health Can you recommend anyone in Central Florida?

[@UCDavisHealth]

Hello! We recommend Karl Illig in Tampa (health.usf.edu/medicine/surgery/faculty/2840931/Illig) or Ying Wei Lum in Baltimore (www.hopkinsmedicine.org/profiles/results/directory/profile/9468452/ying-wei-lum).

[@adrianarce4738]

I need to talk to someone here. My military doctors are leaving me hanging

[@Peev14]

I had this surgery done to me... twice... 2008 and 2012. What are the chances?! (Yes, both my first ribs are removed.)

[@paulconnelly3309]

Hello! Did you have it done on both sides or the same side twice? I had it on my right side in 2003 and now my let side in 2017.

[@SeriouslyBadElf]

Does physical therapy treat this and how long? I started physical therapy 4 weeks ago

[@املماهر-ي5ث]

How are you now???? I have also Thoracic outlet syndrome??

[@abdifataahdeyibseid3269]

❤

[@twhiteprodigy]

Any physicians in the Louisville, Lexington, KY are?

[@IreneIreneArt]

Does hypermobility or Ehlers Danlos Syndrome contribute to TOS?

[@UCDavisHealth]

Joint or connective tissue conditions could potentially contribute to TOS. We recommend a TOS evaluation for anyone experiencing one or more of its core symptoms, including numbness in the fingers or swelling in the arm and shoulder area. The symptoms and diagnosis process are highlighted here on our website: www.ucdmc.ucdavis.edu/vascular/diseases/TOS.html

[@elindenstein]

Anyone specifically in Seattle you could recommend?

[@UCDavisHealth]

Dr. Kaj Johansen: www.swedish.org/physicians/j/johansen-kaj-h

[@johnlloyd9226]

Can you recommend any doctors in San Antonio, TX.

[@UCDavisHealth]

Not in San Antonio, however we can recommend Dr. Gregory Pearl in Dallas: www.texasvascularassociates.com/pearl.htm

[@KimSyracuse-tc9tb]

Okay I was in two car accidents the seat belt and then April 28,2024 I Trip and Fall smash my face and I have like someone is using a typewriter in my whole body going up my arms going up my legs then it starts from the bottom goes along My body ,then I was seating and second my right shoulder in back upper part shot pain from right shoulder over to the Left side down my hand back to the right came upon under my jaw then cracking sound had happened. I didn't know what hit me when I came to felt like someone was rubbing my chest before this happening I couldn't keep my arms up in the air felt like I was going to passed out I thought this was my bursitis arthritis in My shoulder on right side

[@aslandaghighi3736]

Hi, I am a swimmer, is there any way to prevent thoracic outlet syndrome?

[@matthewspurr1425]

Hi Aslan, It depends. It's complex and some pieces may be congenital. Self-massage and proper stretches and posture may help prevent it. But this is no guarantee. Thanks, Matthew

[@naya50]

More advisable to do Physical Therapy BEFORE doing surgery. Do Physical therapy first!

[@AngryGnome87]

I'm homeless living in a car, I think I got this, but my doctor told me that I just have bad posture. but what u just described is exactly how I felt even b4 I started to live in the car. because i have limited funds, other then an operation is there any other treatments?

[@UCDavisHealth]

+Michael Sisson II Please email [e-mail] regarding your request. Thank you.

[@AngryGnome87]

So then that's a no... Lol

[@UCDavisHealth]

+Michael Sisson II Not at all. Please email [e-mail]. We have a couple more questions before connecting you with the right clinical team.

[@juan58102]

good for you... they fix you,,,,, i m dong the stretching, the proper one ,,, so i can avoid to have surgery

[@EthanCrawford-u4z]

Lets just remove your rib.