DEPARTMENT OF NEUROSCIENCES
INTERVENTIONAL NEUROPHYSIOLOGY

UCSD Center for Thoracic Outlet Syndrome (TOS) and
Upper Extremity Pain

Neurogenic thoracic outlet syndrome is a painful condition affecting the nerves of the brachial plexus. Patients typically experience pain in the neck and shoulder often radiating into the arm and hand (usually the last two fingers). 

Symptoms generally increase with activity and with the arms overhead. Patients are often presumed to be suffering with a spine problem or a pinched nerve in the arm. Routine nerve studies often do not reveal the cause.

The most critical first step in the treatment of this problem is accurate diagnosis. At the Center advanced techniques are available for diagnosing this disorder, including detailed nerve evaluations with the arms in the positions which produce the symptoms. In addition, special MRI studies are available which assist in determining the exact source of the discomfort.

When the source is identified, many patients may experience relief of symptoms with proper therapy alone. When the condition is more severe or abnormal structures are present, surgery is often an important part of the management.

Dr. Justin Brown, the center's director, is a member of the scientific advisory board of the American TOS Association (ATOSA) and the Thoracic outlet Syndrome Society (TOSS); he gives talks about this condition across the nation.

Team members

  • Neurosurgeon: Justin brown
  • Clinical neurodiagnostics: Geoffrey Sheean Intraoperative neurphysiology: Jeffrey Gertsch and the UCSD Interventional Neurophysiology Service
  • Radiology: Afshin Karimi (MRI of nerves), Tudor Hughes (ultrasound of nerves)
  • Pain medicine: Gregory Polston
  • Sports medicine: Natalie Voskanian
  • Specialist therapy for TOS: Carter McElroy
  • Basic science: Nigel Calcutt, Wendy Campana