Pain in the Neck: Thoracic Outlet Syndrome and Bicycle Accidents

Following a bicycle crash, feeling pain in the shoulders, neck, and other upper body regions (even in the hands and fingers) can be common. While there are a bevy of reasons why this occurs, it can sometimes be due to compression of the blood vessels and nerves in the space between the neck and shoulders, known as thoracic outlet syndrome (TOS).

TOS, while sometimes difficult to identify and might not always present right away, can be serious, meaning that seeking out the right care is necessary.

If you’re experiencing neck or shoulder pain after a bike crash or other symptoms, it’s important to see a doctor. The attorneys at Bay Area Bicycle Law only deal with bicycle accidents, so we know how important compensation can be to accessing the right care and treatment. To talk with one of our attorneys to see how much you are entitled to after an accident that causes TOS, reach out for a free consultation at (415) 466-8717.

What is TOS?

Thoracic outlet syndrome can occur for a variety of reasons, sometimes it’s due to the presence of an extra rib, while in other cases it can be the result of an accident or sports injury. The group of conditions occur when there’s pressure on blood vessels or nerves in the area between the neck and shoulder, an area called the thoracic outlet. In bike accidents, this might be because the cyclists injures their collar bone — a common phenomenon — and that in turn creates pressure.

This pressure can result in neck and shoulder pain and also other symptoms. Trauma from an accident, such as a bike crash, can cause disturbance of nerves and vessels and lead to some serious symptoms.

The three types of TOS are:

Arterial TOS: This is due to the presence an extra rib, close to the neck, which can compress the subclavian artery and limit blood flow to the arm and hand.

Neurogenic TOS: Doctors say this is the most common form of TOS they see, and often affects the nerves. Tears in the scalene muscles in the neck can cause spasms that then irritate nerves in the brachial plexus. This is the mostly likely type of TOS a cyclist in an accident might develop.

Venous TOS: This type of TOS impacts the subclavian vein. Constantly lifting or throwing a ball, for example, can induce injuries to the vein. Clots and blockages can occur.

Symptoms of TOS

Some of the symptoms associated with TOS can be confused for general soreness and stiffness after experiencing an accident, while others may seem odd and a clue that there’s something more serious occurring.

Main symptoms of TOS include:

• Numbness and tingling in the arms
• A weak grip
• Pains or achiness around the neck, shoulders and hands

Other common symptoms include:

• Swelling in the arm
• Cold fingers and hands
• Weak or no pulse in the arm
• Lack of color (or a bluish color) due to low circulation
• Blood clot
• Throbbing in the collar bone

These symptoms may not always be present immediately following the crash. Sometimes it takes days for them to manifest. When they do, it’s important to seek out expert care. If not treated properly or in a timely manner, TOS can result in a blood clot or pulmonary embolism – both of which can be life threatening. Permanent nerve damage, swelling, and neurological damage is also likely when the condition goes untreated.

Diagnosing TOS

Because symptoms of TOS can closely resemble other health conditions or injuries (such as a rotator cuff injury, for example), it can be difficult to diagnose. Doctors may perform nerve conduction studies, electromyography, or imaging to identify whether TOS is at the root of symptoms.

Treatment of TOS

Depending on the severity of the case, some cases of TOS may require surgery, physical therapy, medication, or a combination of all three.

With surgery, doctors can remove parts of the scalene muscles or clear scar tissue away from the nerves to alleviate symptoms – this is called thoracic outlet decompression. Surgeons can also operate on tendons or remove an extra rib, if it’s present.

If a clot is present, doctors may have to go in and remove it.

Physical therapy in cases of TOS caused by an accident usually aim to strengthen the chest, improve posture, or relieve compression to alleviate the pressure that may be causing symptoms.

Anti-inflammatory drugs may also be prescribed to help lessen pressure, while thrombolytics can break up blood clots and anticoagulants can prevent clots.