Thoracic Outlet Syndrome Clinic

The Johns Hopkins Thoracic Outlet Syndrome Clinic diagnoses and treats all forms of thoracic outlet syndrome (TOS), whether it is neurogenic (nerve compression) or vascular (blood vessel compression). Our experts study your medical history, run tests to rule out similar conditions, and examine you to develop a clear picture of what’s causing your arm and shoulder symptoms.


What is Thoracic Outlet Syndrome; How is it Diagnosed and Treated?

Assistant Professor of Surgery Dr. Ying Wei Lum discusses causes, symptoms and risk factors of thoracic outlet syndrome.

Patient Information: What to Expect

Personalized Treatment

Treatment for thoracic outlet syndrome (TOS) is highly specific to each patient. Expert diagnosis is essential to determine whether nerves or blood vessels are being compressed and which bones or muscles are involved in the compression. If possible, a conservative treatment is often recommended at first — particularly for neurogenic TOS — progressing to injections or surgery only if you don’t find permanent relief with conservative measures.

What to Expect from Your First Visit

Your care team will begin by conducting the following:

  • Complete medical history
  • Physical examination
  • Discussion of symptoms

Thoracic outlet syndrome can sometimes be caused by weight gain, increased muscle mass, injury or repetitive overhead motion. To better understand what might be causing your symptoms, your care team may also ask about:

  • Work and lifestyle activities
  • Recent injuries or changes

Appropriate diagnostic scans may then be performed.

What to Expect from Your Treatment

A customized treatment plan will be developed by your care team based on your type of TOS, the severity of your condition, and previous treatments you have received. TOS treatments include:

 

Our Team

Vascular Surgeons

Other Physicians

Clinic Staff 

Asma Abeer, M.S., PA-C

Physician Assistant

Asma Abeer received her Bachelor of Science in Biology and minor in Gerontology at Ramapo College of New Jersey. She then went on to obtain her Master of Science in Physician Assistant Studies from DeSales University. Following graduation, Asma joined the Division of Vascular Surgery at Johns Hopkins Bayview and has worked there since. Asma primarily manages peri-operative patients in the outpatient setting and assists with vascular patients in the inpatient setting as well.  

headshot of Asma Abeer

Holly Grunebach, P.A.-C., M.S.P.H.

Physician Assistant

Holly Grunebach studied biology and dance at Slippery Rock University in Pennsylvania, then received an MS in physicians’ assistant studies and another MS in public health from Arcadia University. After a year of emergency-room work, Holly entered the Postgraduate Surgical Residency for Physician Assistants program at The Johns Hopkins Hospital. For the last five years, she has worked in the Division of Vascular Surgery. Holly has spent much of that time in the Thoracic Outlet Syndrome Clinic, assisting surgeons in the operating room and at the clinic.
headshot of Holly Grunebach

Lindsay Keilholtz

Triage Nurse

Lindsay received her bachelor’s degree in nursing at Virginia Commonwealth University (VCU). She began her career at VCU Medical Center as a nurse in the cardiac medical intensive care unit where she worked for two years. Lindsay joined Johns Hopkins in 2009 as a nurse in the cardiovascular surgical intensive care unit where she cared for cardiac surgery patients, trained new nurses in the ICU and served as a clinical resource nurse for younger staff. In 2015, Lindsay became the second triage nurse for the Department of Surgery, working with the cardiac and vascular surgery teams. She also serves as the first point of contact for all new cardiac and vascular patients admitted to Johns Hopkins Heart and Vascular Institute.
headshot of Lindsay Keilholtz

Our Locations

Johns Hopkins Bayview Medical Center

4940 Eastern Ave
Baltimore, MD 21224

Johns Hopkins Bayview Medical Center exterior, front view.

The Johns Hopkins Hospital

1800 Orleans St
Baltimore, MD 21287

The Johns Hopkins Hospital

Suburban Hospital

8600 Old Georgetown Rd,
Bethesda, MD 20814
Suburban Hospital

Patient Resources

Surgical Treatment for Thoracic Outlet Syndrome | Mark’s Story

When Mark Norwich was determined to find a treatment for thoracic outlet syndrome that would allow him to start in his college football program. The Norwich family traveled from New York City to Baltimore to see Dr. Ying Wei Lum. Mark and his family tell the story of the surgical treatment, rehabilitation and recovery from thoracic outlet syndrome.

Treatment for Thoracic Outlet Syndrome | Aaron's Story

Aaron Hoover first felt the shoulder pain while pitching in a college baseball game. After numerous tests and scans, Aaron's doctor found a blood clot — a major clue that he had Thoracic Outlet Syndrome. Aaron talks about his experience with the Johns Hopkins Thoracic Outlet Syndrome clinic, from surgery to recovery.

Transaxillary First Rib Resection for Thoracic Outlet Syndrome (TOS)

Learn more about the tranaxillary first rib resection surgical approach to treat TOS from the Johns Hopkins Thoracic Outlet Syndrome Clinic. Watch to find out what happens during and after this decompression surgery, which is a low risk and effective surgical treatment for patients diagnosed with neurogenic or venous TOS.

Nerve Block Treatment for Thoracic Outlet Syndrome (TOS)

Nerve Block is a non-surgical alternative for patients suffering from Thoracic Outlet Syndrome (TOS). This animation illustrates how physicians at the Johns Hopkins Thoracic Outlet Syndrome Clinic perform interscalene brachial plexus blocks using botulinum toxin type A injections to provide temporary pain relief for patients.