title: Thoracic outlet syndromes. The so-called "neurogenic types".
abstract: Neurogenic thoracic outlet syndrome (TOS) is one of the most controversial pain syndromes of the upper limbs. The controversies revolve around both the diagnosis and treatment of the non-specific or subjective subtypes. Their diagnosis rests on a combination of history, suggestive symptoms and clinical examination. Proximal pain is primarily muscular in origin, while distal symptoms may be the result of intermittent nerve compression and/or myofascial pain syndrome. Stringent clinical criteria are required to confirm the diagnosis of subjective TOS. In reality, multiple factors can be entangled, with TOS being one element within a multifactorial pain disorder; any musculotendinous pathology of the upper limb and any peripheral nerve entrapment require screening for potential concomitant TOS. Surgery is indicated in most cases of true neurogenic TOS, whereas rehabilitation is the standard treatment for subjective TOS.
authors.affiliation: Hand Surgery Unit, Department of Orthopedic Surgery, Hôpital Trousseau, University Hospital of Tours, avenue de la République, 37170 Chambray-lès-Tours, France. Electronic address: j.laulan@chu-tours.fr.
authors.forename: J
authors.initials: J
authors.lastname: Laulan
mesh_terms: D001917:Brachial Plexus; D006801:Humans; D063806:Myalgia / Q000209:etiology; D009408:Nerve Compression Syndromes / Q000150:complications; D009437:Neuralgia / Q000209:etiology / Q000601:surgery; D013901:Thoracic Outlet Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000534:rehabilitation / Q000601:surgery; D034941:Upper Extremity
keywords: Compressions nerveuses étagées; Double-crush syndrome; Myofascial pain syndrome; Neurogenic thoracic outlet syndrome; Syndrome douloureux du membre supérieur; Syndrome myofascial; Syndromes de la traversée neurologiques; Upper limb pain syndrome