I have had TOS symptoms for the last 8 years. I have had bilateral CTS release with partial improvement, r ulnar release last yr with no improvement. My symptoms started while working at the computer and at night, then progressed to most of the time. I was discharged from my occ med MD and then within 2 months was referred to a vascular surgeon (I have seen three so far at Kaiser). They all give me a 50% chance of improvement with rib resection; I also saw one MD outside and he felt I had a better chance of improvement. In general things are slowly progressing. I have pain in the ulnar distribution in both arms at night, cramping pain during day if I use them and major pain in the shoulder girdle along scapula, under arm ind into chest, numbness at night and strange parasthesias during the day. I also get goosebumps and sharp shooting pains in my right arm if I use it too much. My right hand swells in certain positions but no white hand symptom. Headaches almost daily when using arms- right side posterior. I am only taking Nortriptyline at night to sleep through the pain. I am not going to try narcotics since I know they only help at first...I have done PT long therapy x 2 since this all started. I was a swimmer, worked out all of the time and now only do yoga which I have to modify. I am a nurse who has worked on a computer for the past 12 yrs. I am probably going to have surgery. I have broad shoulders and put on muscle very easily- in fact one of the MDs commented on the fact that this could play a role.