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Thoracic Outlet Syndrome Overview

Thoracic outlet syndrome occurs when the nerves, arteries or veins are compressed in the thoracic outlet region, which is located between the base of your neck and your upper chest. This can lead to shoulder, arm, or hand pain due to the narrowing of this space. Thoracic outlet syndrome can be caused by numerous factors, including injuries, poor posture, or anatomical defects (for example, having an extra rib). Three main types of thoracic outlet syndrome exist: neurogenic, arterial, and venous. 

  • Neurogenic thoracic outlet syndrome is the most common form of the condition. It is caused when the brachial plexus nerves in this area become compressed.
  • Arterial thoracic outlet syndrome occurs when a blood vessel is compressed, leading to decreased circulation and pain in the arms or fingers.
  • Venous thoracic outlet syndrome is caused by a narrowing of the veins in this region, leading to swelling and pain. 

Symptoms Of Thoracic Outlet Syndrome

Symptoms associated with thoracic outlet syndrome vary, depending on the type.

  • Neurogenic symptoms include pain in the neck, shoulders, or arms; tingling or numbness in these areas; and weakened grip strength.
  • Arterial symptoms include discoloration of the fingers or hands when exposed to cold temperatures, a decreased pulse in the affected areas, and hand and arm pain. It can also cause your fingers, hands, and arms to feel cold.
  • Venous symptoms include swelling or discoloration of the affected area, as well as pain and fatigue. It can also cause blood clots to develop in the upper part of your body and throbbing lumps in the collarbone.
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Conventional Treatment Options 

Conventional treatment depends on the severity of the symptoms you’re experiencing. If symptoms are on the milder side, doctors will typically recommend medications. However, the issue with this course of treatment is that it does not address the root of the problem. Instead, it’s just masking the symptoms.

If the symptoms are severe, then the doctor might recommend surgery. You should be aware that surgery comes with many risks of complications, such as infection, allergic reaction, excessive bleeding, scarring, and nerve damage. Additionally, surgery often requires lengthy recovery times and can be very expensive to boot. 

The following is a brief overview of some of the more conventional treatment options for thoracic outlet syndrome:

Corticosteroid Injections

Injecting a corticosteroid medication can help reduce inflammation and pain. In the case of thoracic outlet syndrome, the medication will be injected in the area around the ribs or between your shoulder and neck muscles. Reducing inflammation in these areas can help alleviate some pressure on the nerves and thus reduce the symptoms. However, these injections only provide temporary relief, which means regular injections are necessary to maintain the effects.


NSAIDs are non-steroidal anti-inflammatory drugs that can help reduce inflammation and pain. Common over-the-counter NSAIDs include ibuprofen and naproxen, while stronger ones (like diclofenac) must be prescribed by doctors. They can be taken orally, or as a topical ointment applied to the affected areas. However, taking too much of this medication can result in serious side effects, including stomach ulcers and kidney damage. The relief that they provide is even more temporary than corticosteroid injections.

Balloon Venoplasty

Balloon venoplasty is an invasive procedure in which a thin tube with an inflatable balloon is inserted into the affected vein of the thoracic outlet. The balloon is inflated to help open up the vein and make more space for blood flow. Doing so can reduce swelling and pain associated with venous thoracic outlet syndrome. Despite being minimally invasive (in surgical terms), it still carries some risks, such as infection or bleeding.

First Rib Resection

In more severe cases, doctors may recommend surgically removing the first rib, which is the most common cause of thoracic outlet syndrome. Removing the rib can provide more space for the nerves and blood vessels, relieving pressure and thus reducing pain. However, this procedure is highly invasive and carries several risks, including nerve damage, infection, and excessive bleeding. It also requires an extensive recovery period.


What Is Platelet-Rich Plasma, Or PRP? 

PRP is an alternative treatment that has been shown to provide longer-lasting effects than conventional medications, without being invasive or risky. It involves taking a sample of your blood and separating out the platelets, which are injected into the affected area. Platelets contain growth factors that help reduce inflammation and stimulate cell regeneration. Essentially, the treatment uses the body’s own healing system to help alleviate pain and promote healthy tissue growth.


PRP For Thoracic Outlet Syndrome

PRP treatment can help provide relief for patients suffering all forms of thoracic outlet syndrome, whether neurogenic, arterial, or venous. 

When it comes to neurogenic thoracic outlet syndrome specifically, PRP treatment can help reduce numbness and tingling in the affected area, as well as improve grip strength and range of motion. It does this by providing nourishment and stimulating cellular regeneration in the area, which helps promote the healing of any nerve damage. 

For arterial thoracic outlet syndrome, PRP helps reduce inflammation of the affected blood vessels, thus allowing for improved circulation and reduced pain. It can even help improve discoloration of the extremities when exposed to cold temperatures by assisting in the regeneration of healthy blood vessels. 

Finally, PRP can help reduce swelling and pain associated with venous thoracic outlet syndrome by alleviating pressure on veins and stimulating tissue growth. In addition, PRP can help reduce the formation of blood clots by promoting better circulation in the area.

Why Are Orthagenex PRP Injections Superior?

Although PRP injections are considered an “alternative treatment” to more conventional solutions, they are not uncommon. However, despite being derived from the patient’s own blood, not all PRP products are created equally. At Orthagenex, the way we process and deliver PRP treatments is superior to most others. The following are the reasons why:

Image-Guidance To Place PRP Solutions

Conventionally, PRP treatments are delivered via blind injections. This means that the solution is injected using a needle without technology or imaging. This can be imprecise and can result in the PRP solution not being placed exactly where it is needed. 

At Orthagenex, we use advanced technologies like musculoskeletal (MSK) ultrasound and fluoroscopy to inject our PRP treatments. These technologies provide real-time imaging, allowing us to precisely place the platelet concentrations right where they are needed. This helps ensure greater success rates for our treatments and reduces any potential risks associated with them.

Lab-Processed For Higher Concentrations of Platelets

Most PRP solutions are processed by taking the patient’s blood sample and centrifuging (spinning) it in a machine. However, at Orthagenex, we take this process to the next level with our lab-processed PRP solutions. This allows us to customize and standardize the quantity of platelets that each patient receives. 

In fact, because we process our PRP treatments in a lab instead of a bedside centrifuge, our solutions have as many as 10 to 30 times higher concentrations of platelets than conventional PRP treatments. This helps ensure that our treatments are more successful and longer-lasting in providing relief for those suffering from thoracic outlet syndrome. 

Additionally, the use of a specific lab platform also allows us to develop the following treatment solutions:

Amber PRP vs. Red PRP

Standard PRP solutions are called red PRP. This is because red PRP contains more red and white blood cells than platelets. However, at Orthagenex, we also provide amber PRP solutions. This advanced form of PRP removes the excess red and white blood cells from the solution without sacrificing any platelet concentrations. 

The advantage of this type of PRP is that it packs more healing factors with fewer inflammatory components, making it an ideal choice for certain conditions.

Next-Generation Platelet Lysate 

Platelet lysate, or PL, is the next level up from PRP. The primary difference between PL and PRP is that PL solutions are even less likely to trigger an inflammatory response – and they release their healing factors immediately, whereas PRP solutions release their healing factors over a period of time – in a manner that’s not unlike a timed-release pill. Generally speaking, we’ll recommend PL treatment if the injection needs to be administered near the spine.

PRP Customized To Every Patient’s Need

Because we process our PRP solutions in a lab, we have more control over the concentrations and components of our treatments. This allows us to customize PRP solutions for each patient based on their individual needs, giving them the best chance at experiencing a successful treatment. The following are a few ways that we can do this:

Solutions Are Customized Using Lab-Processed PRP Solutions

The specific lab platform we use allows us to customize our PRP solutions for each patient. We can adjust the quantity of platelets in a solution, as well as its concentration of growth factors and other regenerative compounds. Additionally, we can remove any components that could be detrimental to the patient’s condition before introducing the solution to their body.

Bone Marrow Concentrate Can Be Used 

Bone marrow contains various regenerative and healing compounds, including proteins known as cytokines and mesenchymal stem cells. At Orthagenex, we can take the patient’s bone marrow concentrate (BMC) to help create a customized solution that can be used to treat their condition. We will often use BMC alongside PRP or PL treatments, depending on the condition we’re treating.

Doctors Specializing In Interventional Orthopedics

Interventional orthopedics is a relatively new field in medicine, and doctors who are board-certified and fellowship-trained in this specialty are highly sought after for their expertise. So far, only 1% of US physicians are trained in interventional orthopedics.

At Orthagenex, all our physicians are board-certified or fellowship-trained in interventional orthopedics. This allows them to provide patients with the highest level of care when it comes to PRP treatments for thoracic outlet syndrome.

Core Competencies

As board-certified and fellowship-trained orthopedic doctors, our team at Orthagenex has expertise in a variety of core competencies related to interventional orthopedics. This includes performing SANS (stability, articulation, neuromuscular, and symmetry) evaluations to identify the root cause of the problem and develop an individualized treatment plan that best suits a patient’s needs. 

Additionally, our team is also well-versed in the use of various imaging technologies like MSK ultrasound and fluoroscopy – both of which are used to ensure that treatments are delivered accurately and with minimal risk. This helps us provide more successful treatments with fewer complications. 

Overall, our team of highly trained interventional orthopedic specialists can provide you with the highest level of care when it comes to treating thoracic outlet syndrome with PRP.


Orthagenex – Your Alternative To Thoracic Outlet Syndrome Surgery

At Orthagenex, we understand the challenges faced by those who are suffering from thoracic outlet syndrome. That’s why our team of highly trained orthopedic doctors and our advanced technology allow us to provide patients with long-lasting relief without having to resort to surgery. 

Our PRP treatments are tailored to each patient’s individual needs. With our customized solutions, we can provide you with a safe, non-invasive alternative to thoracic outlet syndrome surgery that will help you achieve long-lasting relief from your condition.

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