Sore Shoulder Could Be Sign Of Serious Clot Condition: Thoracic Outlet Syndrome

Thoracic outlet syndrome can be underdiagnosed, treatment may mean rib removal

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After persistent soreness in her arm, Sandy Niehaus developed blood clots in her right arm due to a condition known as thoracic outlet syndrome. Treatment required Dr. Patrick Vaccaro to remove most of Niehaus` first rib to relieve the pressure.

(COLUMBUS, Ohio) – Shoulder tightness and pain is common among athletes and those who work with their arms in the same position for long periods of time, but a more serious condition may develop that often goes undiagnosed for years. It’s called thoracic outlet syndrome. The condition is a compression of the vein, nerves or artery that runs between the collarbone and the first rib. In severe cases, it can cause large and often dangerous blood clots.

When physical therapy can’t resolve the issue, doctors perform surgery to remove part of the first rib, opening up the area and relieving the pressure.

“I’ve had several patients tell me it’s been life-changing. You remove part or most of the rib, and it’s the first time they remember not being in pain,” said Dr. Patrick Vaccaro, director of vascular diseases and surgery at The Ohio State University Wexner Medical Center. “You might think it’s a minor thing to take out a piece of a rib, but for these people it’s really important that they have this diagnosed and fixed.”

Thoracic outlet syndrome is commonly caused by repetitive overhead motions and can be seen in anyone from tennis players or swimmers to musicians, trade workers and those who sit at a desk with their arms too high. Only about a third of people who develop the disorder can recover with physical therapy. Most will ultimately need surgery.

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Sandy Niehaus is examined by Dr. Patrick Vaccaro at The Ohio State University Wexner Medical Center. Niehaus developed a large blood clot due to a condition known as thoracic outlet syndrome, which can pinch nerves, veins or arteries between the collarbone and first rib.

After persistent soreness in her arm, Sandy Niehaus developed blood clots in her right arm due to a condition known as thoracic outlet syndrome. Treatment required Dr. Patrick Vaccaro to remove most of Niehaus` first rib to relieve the pressure.

Athletes who use overhead motions can develop a condition that compresses the nerve, vein, or artery between their collarbone and first rib, but the condition - known as thoracic outlet syndrome - can also be caused by sleeping in the fetal position or working at a desk with your arms too high.