Thoracic outlet syndrome
BMJ 2012; 345 doi: https://doi.org/10.1136/bmj.e7373 (Published 09 November 2012) Cite this as: BMJ 2012;345:e7373- Lauren Deane, patient1,
- Henk Giele, consultant2,
- Karen Johnson, general practitioner 1
- 1Poplar Grove Practice, Aylesbury, Bucks HP20 1XB, UK
- 2Plastic, Reconstructive and Hand Surgery, Nuffield Orthopaedic Centre, Headington, Oxford, UK
- Correspondence to: L Deane lauren85{at}live.co.uk, karenjohnson{at}nhs.net
- Accepted 25 August 2012
It all started around nine years ago when I was 17; I began to get a strange tingling and a dull ache in my left arm. I noticed I couldn’t carry a bag over my left shoulder, as my arm seemed to go numb and achy. At the time I was training at college to be a beauty therapist. I kept getting strange electric shock sensations and stabbing pains and the feeling of a dead heavy arm, but I remember putting it down to over-working at college and at work. I ignored it for as long as possible. I mentioned it in passing while seeing my general practitioner for an unrelated matter.
I explained to my doctor the pains and symptoms I had been getting. She then carried out some sensory tests on my arm. I watched a needle being pressed on my arm and hand and knew it should be hurting or at least feeling sharp, but I couldn’t feel it at all. The general practitioner pointed out that I had muscle wastage in my left hand; my palm was indented and my tendons could be felt, I had no pad of muscle under my thumb area, and the back of my hand also looked thin. I had not noticed this before.
My doctor arranged an urgent appointment for me to see a neurosurgeon. From then on I had so many tests I can’t even remember the number—nerve conduction studies with needles and electrodes, vascular scans, magnetic resonance imaging, radiography, etc—and everyone seemed to be confused by the results.
Eventually I was told I had a condition called thoracic outlet syndrome and …