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Thoracic outlet syndrome is a combination of pain in the neck and shoulder, numbness and tingling of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collar bone. Causes Blood vessels and nerves coming from the spine or major blood vessels of the body pass through a narrow space near the shoulder and collarbone on their way to the arms. As they pass by or through the collarbone (clavicle) and upper ribs, they may not have enough space. | Thoracic outlet syndrome Thoracic outlet syndrome is a combination of pain in the neck and shoulder numbness and tingling of the fingers and a weak grip. The thoracic outlet is the area between the rib cage and collar bone. Causes Blood vessels and nerves coming from the spine or major blood vessels of the body pass through a narrow space near the shoulder and collarbone on their way to the arms. As they pass by or through the collarbone clavicle and upper ribs they may not have enough space. Pressure compression on these blood vessels or nerves can cause symptoms in the arms or hands. Problems with the nerves cause almost all cases of thoracic outlet syndrome. Compression can be caused by an extra cervical rib above the first rib or an abnormal tight band connecting the spinal vertebra to the rib. Patients often have injured the area in the past or overused the shoulder. People with long necks and droopy shoulders may be more likely to develop this condition because of extra pressure on the nerves and blood vessels. Thoracic outlet anatomy Thoracic outlet syndrome is a rare condition that occurs when there is compression of vessels and nerves in the area of the clavicle. This can happen when there is an extra cervical rib or because of a tight fibrous band that connects the spinal vertebra to the rib. There may be pain in the neck and shoulders and numbess in the last 3 fingers and inner forearm. Thoracic outlet syndrome is usually treated with physical therapy which helps strengthen and straighten out the shoulders. Symptoms Symptoms of thoracic outlet syndrome may include - Pain numbness and tingling in the pinky and ring fingers and the inner forearm - Pain and tingling in the neck and shoulders carrying something heavy may make the pain worse - Signs of poor circulation in the hand or forearm a bluish color cold hands or a swollen arm - Weakness of the muscles in the hand Diagnosis Tests When you lift something the arm may appear pale due to pressure on the .