A Bruise or Thoracic Outlet Syndrome?

Thoracic outlet syndrome (TOS) can sometimes start out looking like a bruise but can be dangerous if left untreated. TOS describes a group of disorders that occur when nerves and/or blood vessels (arteries and veins) in the lower neck and upper chest area become compressed, injured, or irritated.

Symptoms of Thoracic Outlet Syndrome vs. a Bruise

There are three different types of TOS, so signs and symptoms can vary:

Neurogenic (neurological) TOS
Most cases (90%) involve neurogenic TOS (nTOS), which affects the brachial plexus. This is a network of nerves extending from the backside of the base of the neck through the armpit. Symptoms can include:

• Pain or weakness in shoulders or arms.
• Pain or aches in the neck, shoulder, or hand.
• Numbness or tingling in arms or fingers.
• Arms tire easily.

These symptoms often overlap with other conditions, resulting in many patients suffering from nTOS for months or years before a diagnosis.

Venous TOS
At least one vein under the collarbone is compressed, which can cause blood clots or Paget-Schroetter syndrome (effort thrombosis). Symptoms include:

• Bluish hands and arms (which can look similar to bruising).
• Intermittent arm swelling
• Tingling in hand and arm, often painful.
• Increased prominence of veins in neck, shoulder, and hand.

Arterial TOS
At least one artery under the collarbone is compressed. Symptoms include:

• Cold, pale fingers or hands.
• Hand pain or weakness, often sudden.
• Blockage (embolism) of an artery in the hand or arm.
• Tingling, numbness in fingers.
• Wounds or ulcerations in the fingers that don’t heal properly.
• Arm fatigue when in use.

Bruise Symptoms

A severe bruise is also referred to as a hematoma. It occurs as a result of damage to one of the larger blood vessels in the body. Symptoms include:

• Discoloration (e.g., purple, blue, red, black, yellow)
• Inflammation and swelling
• Tenderness in the area
• Redness
• Warmth in the skin surrounding the hematoma
• Pain

Sometimes, a hematoma may require surgical drainage, for instance, if the blood puts pressure on the spinal cord, brain, or other organs. The primary ways to distinguish TOS from a bruise are that the pain of TOS typically increases when raising the affected arm, and there will normally be tingling or a loss of feeling.

What Causes Thoracic Outlet Syndrome?

Trauma is one of the most common causes of TOS, such as car accidents. In collisions, the body may be suddenly thrown or experience a prolonged crushing sensation or pinning of the shoulder, which can lead to the condition. Repetitive stress is also a primary factor in TOS, for instance, due to work-related tasks such as carrying heavy shoulder loads or participating in sports that require repetitive arm or shoulder movement like baseball, golfing, volleyball, swimming, etc. Other causes include stress or depression, weightlifting, poor posture, sleep disorders, or tumor or large lymph nodes in the upper chest or underarm area.

A Personal Injury Lawyer Can Help

If you are suffering from Thoracic Outlet Syndrome as the result of an injury, our St. Louis Personal Injury Lawyer can help you determine if there is anyone to hold legally responsible. Call (314) 231-4100 or message us online to schedule a free consultation today.