I'd say when your arms are raised those c ribs are causing more compressions.

Oh man , I remember the burning feelings... I would get it at the "hump" area of my back and all across my shoulders. My fingers didn't tingle but I would get sharp cramps in the back of my hands and my forearm muscles would get very sore and feel strained , took ages to get that resolved.
Mainly because the problem was based up in my neck and PT was only focusing on my hand/arms for RSI like symptoms.
Finally after another evaluation from a more advanced PT she found the true cause and I got the more helpful therapies then.
After those PT sessions were done I found my chiro & an independent PT guy on my own.


For the most part we usually suggest trying good PT first to see if any helps reduce symptoms.

If you can avoid most pain/symptoms by modifying activities I would wait on the surgery.

Most with TOS are in quite severe and constant pain before they finally have surgery.

For now at least you do know that those c ribs are the main culprit, as opposed to those that have soft tissue causes or no obvious anomalies to cause their pain & symptoms.

I would take the time to seek out the best surgeon that you can and have him evaluate your situation, and a good one should also know of an excellent PT place to refer you to.

Great, thanks for your help. I am thinking I would like to go the PT route first depending on how the nerve damage affects things. I don't understand a lot of it, but would rather try again with PT(did it last year before carpal tunnel surgery)

do you recover completely and get full strength back after surgery? I didn't know if the re-section of the c ribs limits your recovery or only gets you back to close in strength.

thanks, Rob

I'm sure many do recover, we just don't see them on forums because they are doing well & functioning fairly well.

Hank Blalock the texas rangers ballplayer had surgery last year and is back to playing ball. - but he is also having misc other injuries that take him in & out of the active roster... makes me wonder about the spread of myofascial issues..
many of us seem to have that sort of problem.

Ahhh , you had a carpal tunnel surgery already ...that might have been what is called a double crush syndrome .... {when compression is in 2 places- outlet & wrist or outlet & ulnar, there can also be a triple crush involving all three area}
Did your hands recover well?

you might find some info in these that will be of help-
http://neurotalk.psychcentral.com/post87845-19.html
http://neurotalk.psychcentral.com/post85992-18.html

my hands still have symptoms of the carpal tunnel , still get numb(not as often though) and they can't grip either like they used to.

saw the surgeon today, he has asked for an mri to get definitive answers in 3-d of some areas.

he said with my symptoms surgery will be inevitable, but we won't rush into it right now, have to see the results from the mri.