Hi Sue, I have been diagnosed with the muscular(scalene?)type of TOS, you can visable see bulges in my neck, shoulders thru out the scapular muscles and biceps. My massaage therapist is always in awe and cannot believe the tightness/bulges everytime, I also have severe pain in both arms, they throb constantly along with radiculopathy (nite time the worse, 3-4 hrs of sleep if lucky) in the shoulders, biceps, elbows, forearms and numbness in my hands. I still have issues with ostoephytes @ C4/5, C5/6 and C3/4 disc heniation after my 3 level ACDF surgery in 09. I am going to my Dr's this morning to get my bone scan results finally. Please do your research on the rib removal, ask doc lots of ?s, and rate of successful surgeries. My neuro offered to do a posterior foramintomy(?) And my husband and family doc advised me, well actually said no! Surgery may not always be the anwser, but if the symptoms and pain is relentless then you do what you feel is best for you. Bunz