Representation of the thoracic outlet syndrome as a problem in chronic pain and psychiatric management

The diagnosis of thoracic outlet syndrome depends upon subjective complaints and sometimes rather limited physical findings. There is a tendency to favour other non-specific diagnoses, like 'soft tissue damage' or to suspect neurosis, particularly in patients who have had motor vehicle or other injuries for which they claim compensation. We report here 3 patients in whom the diagnosis of thoracic outlet syndrome was overlooked and who responded to surgical treatment with good or excellent results.