Sounds like you've exhausted the conservative route. Not sure what your options are at this point other than to risk a surgery if symptoms are debilitating. Have you had an EMG/NCV test done by any neuro(s)? If they come back normal, you'd likely be dx'd as disputed NTOS. From research, disputed NTOS fares relatively poorly in surgery, compared to other TOS types. As such, I'd be reluctant to gamble... but that's just me.

I'm in the same boat, bilateral NTOS - probably disputed. My EMGs/NCVs came back normal. Going to see another specialist to explore future options but I am not in a rush to have the surgery. You can always "do" the surgery, but can't "undo" it. And the risk of complications are very high.