I have a cervical rib and have had symptoms since I was a teenager, probably when the cervical rib was growing and attaching to my first rib. I was finally diagnosed in my early thirties. At that time, I was told it was "up to me" and advised that the cure can be worse than the diagnoses, ever since I have been managing my symptoms with yoga practice (for which i have gained a 1/2 inch in height) and massage and acupuncture when I have flare-ups. This last February, I was rear-ended and suffered whip-lash and seat-belt compression across the collarbone, so I revisited my issues with new doctors. Over the last 5 years, I have had 3 surgeons tell me to get the surgery, one say no, and to PTs tell me no. But here's my issue with your situation: you had no symptoms until your 40s.

I honestly believe that your body-building (combined with having a rib-extension) has had more to do with your developing your problem, then anything else. It's time to bulk-down, focus more on stretch principles and look into Postural Restoration (PRI). This is in the US, but it's an amazing approach that I think all non-cervical rib TOS'ers should do.

This is assuming that you do not have arterial/venous blood supply issues. I have bi-lateral cervical ribs. My left side, I can cut off my blood supply just by raising my arm into certain positions, my right side has none of these issues. I am likely getting Sx on the left and (hopefully) never on the right. I am going to one more PRI training this weekend, and this will be a great factor in determining what I am going to do. But, my Dr's have said this is the one and only reason they are suggesting the Sx. If I didn't have blood supply issues, I wouldn't even consider Sx.

I think I will end up getting the Sx because over the last 30 years, it has gotten progressively worse, and even Jack Lelanne's body was not as tall and straight when he died than when he was in his prime. So, for me, it's a matter of getting it while I am relatively young (39), very fit, and able to recover versus doing it when I am in my 60-80s and healing less well.

For you, it might be as simple of a solution to return your body to a more "normal" stasis. Very few body-builders spend equal time stretching. I am also curious if you have used artificial enhancement techniques? I don't need an answer, most won't admit to it, but you know and this might also be a factor to consider or eliminate from your practice.

Good luck, hope that helps in your equation.