Article

Current Pain and Headache Reports

, Volume 15, Issue 1, pp 14-21

Updated Perspectives on Neurogenic Thoracic Outlet Syndrome

  • Paul J. ChristoAffiliated withDepartment of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins University School of Medicine Email author 
  • , Kai McGreevyAffiliated withDepartment of Anesthesiology and Critical Care Medicine, Division of Pain Medicine, Johns Hopkins University School of Medicine

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Abstract

Pain represents a foremost feature of neurogenic thoracic outlet syndrome (NTOS). Similar to other persistent pain conditions, the physical discomfort associated with NTOS can cause severe and often debilitating symptoms. In fact, those suffering from the syndrome report a quality of life impacted as significantly as those with chronic heart failure. This evidence-based literature review focuses on the classification, etiology, clinical presentation, diagnostic measures, and surgical treatment of NTOS, with a focus on nonoperative therapies such as physical modalities, pharmacological therapies, and more contemporary minimally invasive intramuscular treatments with botulinum toxin.

Keywords

Thoracic outlet syndrome Botulinum toxin Scalene muscles Pain relief Neurogenic thoracic outlet syndrome Brachial plexus Computed tomography Ultrasound Fluoroscopy Electromyography Rib resection and scalenectomy Anterior scalene muscle Minimally invasive treatments