Went back to Dr Michael Donahue at Mass General a couple weeks ago. Last we had left it prior to summer, he had told me that I had an elongated transverse process on C-7 per their special CT Scan, but considering that my symptoms were diminishing to see how it goes and checkin during the Fall. He had mentioned that if "I can't get over the hump" with my own stretching routine, we could look into the CT guided botox injection. I felt like I couldn't kick this thing so I went back to his office.

Dr Donahue then showed me the CT Scan and to my dismay he went on to show me that not only do I have an elongated transverse process, but I also have a cervial rib that has formed. Ugh! The dreaded extra rib.

So we're going down the path to explore the CT guided botox injection in the scalene muscles. He's indicated that many times this works for about 2/3's of his patients. That said, it's a pain in the neck to get the insurance company to approve, but it's in process anyways. I'm not in excruciating pain so it's not critical that I get it done asap.

Anyways, I'm a bit disturbed by this new finding. My situation came on two years ago when I suffered some kind of upper trap/shoulder injury. This, combined with me being in a wound up/tight state due to bodybuilding along with being way too internally rotated seemed to be the perfect breeding ground for TOS. The cervical rib must be the icing on the cake. Add all those variables to the rib and bam...radiating scap pain and pain down to the elbow.

Now, as Dr Donahue explains it, I lived a good 41 years of my life with a cervical rib and without any issue whatsoever. He also thinks that since my symptoms have gotten much better over the last few months due to my own stretching and strengthening work it's very possible that I'm in the process of unwinding this whole situation.

I guess the question I have to the group, especially those with cervical ribs is, once your TOS symptoms emerged, did you find a way to put those symptoms into dormancy? Or is it a situation that you just have to manage as best you can because once it's "out of the box" it's just out there for good?

What I fear is that this is a situation...without surgery...that's something I have to manage very carefully...forever...while dealing with pain here and there. And worse case, it's really inevitable that I have to get a rib resection. I'm 43 right now and in the best shape of my life. As each day/year goes by, I'd imagine that this situation deteriorates.

Anyways, any thoughts would be helpful.

Thanks.

KY