I have a question I've been personally researching to try and get answered but have not been able to, hopefully someone knowledgeable like shengggmd can help me out here.

Basically I have a very weird clinical background when it comes to nerve entrapment, while my TOS symptoms are by far my worst and account for 90% of my daily woes, I also have multiple other entrapments that would basically almost never be seen together in one patient, and especially not a 25 year old. I've developed cubital tunnel in my right arm recently, my NCV shows slowing across my radial tunnel, then I have multiple lower extremity entrapments.

Docs suspect I may have something weird/rare going on that would cause entrapment like HNPP, but as of now that hasn't been decided, but if not I just have really bad luck or anatomy :P

Anyways, this has led to my question I'm trying to get answered. In a normal person without typical TOS, would there still be pressure on the nerves as they pass through to the arms, just not enough to cause any problems? For ex, even a normal healthy carpal tunnel has 30 mmHg of pressure, which is no problem for a normal person and they wouldn't have carpal tunnel till pressures reached >100, but in someone with a genetic condition like HNPP (increased nerve sensitivity) even these normal anatomical pressures cause symptoms.

So I'm trying to see if a similar phenomena is possible with the thoracic outlet or pec minor space, do the scalenes and other structures still put some pressure on the nerves in a normal person, or is the nerve nowhere near being entrapped? I mean is the nerve normally pretty tight fit or is it more like a tennis ball going through a hulahoop lol.

They are telling me I need surgery, all the tests for thoracic outlet are positive, but I'm just trying to make sure I don't do anything I'll regret should the root cause of my problem not be so simple. Like I don't want to get my normal thoracic outlet hacked up if it turns out I have something like HNPP, because from what I read surgery doesn't help in these patients.