Thoracic Outlet Syndrome

St. Vincent Center for Treatment of Thoracic Outlet Syndrome

At St.Vincent, Indianapolis, Vascular Surgeon George Sheng, MD, has created a multi-disciplinary approach to diagnosing and treating thoracic outlet syndrome (TOS) to significantly improve a patient’s quality of life. TOS is associated with nerve and blood vessel entrapment in the shoulder and arm. Dr. Sheng and colleagues diagnose TOS in adults and children who work extensively doing overhead tasks, including athletes in swimming, baseball, softball and volleyball. In many cases the pectoralis minor muscle is also injuried. This multi-disciplinary center includes a thorough evaluation and onsite diagnostic testing, a specialized physical therapy approach, trigger point injection program, botox injection and surgical interventions.

When left-sided shoulder pain is present, St.Vincent physicians always rule out heart disease and use nerve-conduction studies to rule out other causes of nerve pain in the neck and shoulder. Trigger point pain in the pectoralis minor muscle (radiating through the shoulder, pecs and shoulder blade) may occur secondarily to underlying heart disease and may be related to TOS. The TOS staff provides comprehensive follow-up care for all types of TOS including pectoralis minor syndrome. 

Types of TOS

Universally, this condition is caused by the compression of body structures (nerves and blood vessels) in the neck and upper chest area. Our vascular physicians are highly experienced in diagnosing and treating this often misdiagnosed condition.

Thoracic outlet syndrome (NTOS) and pectoralis minor syndrome (PMS) are the most common and presents with series of vague neurological symptoms, ranging from numbness and tingling in hands and fingers with activity -- to weakness and debilitating pain in shoulder, neck, and arm. To learn more about NTOS click here.

Venous thoracic outlet syndrome (VTOS) causes a blood clot to form in deep venous system in the affected arm. As result of the upper extremity deep venous thrombosis (DVT), a patient can have debilitating arm swelling and even a life-threatening pulmonary embolism. To learn more about VTOS click here.

Arterial thoracic outlet syndrome (ATOS) is an exceedingly rare form of TOS and is frequently associated with the presence of an extra rib (referred to the 1st rib or cervical rib) on the affected side. ATOS can be limb threatening due to aneurysm formation in the artery.  To learn more about ATOS click here.

Multi-dimensional Approach to Care

The St.Vincent Center for Treatment of Thoracic Outlet Syndrome attracts patients from throughout Indiana and the nation. Our staff has streamlined the patient experience so that during a 2-3 hour appointment all the necessary tests, a thorough evaluation, and a personalized treatment plan can be developed.  Online consultations are also available to individuals seeking a second opinion. Please contact our office to schedule an appointment or consultation.  

  • Thorough evaluation and diagnostic work-up, including vascular imaging studies
  • Cutting-edge trigger point injection therapy
  • Comprehensive surgical treatments
  • Specialized physical therapy (often available near home)
  • St. Vincent Sports Performance expertise and therapy to return patient-athletes to their sport and recreational activities
  • Meticulous patient follow-up
  • Ongoing clinical research in minimally invasive techniques