Ashley has he tried any type of PT or soft tissue release on this pec minor, scalenes, Str his upper back. Sounds like he has a vascular form of TOS. If he does require surgery the outcome of that type is usually better than neurogentic. If he is in that much pain the doctors need to control it with medication. I would recommend seeing a good vascular surgeon in the area or pain management to control his pain level until you find a cure. It's very important that he has his pain somewhat controlled.