I have ongoing problems with thoracic outlet syndrome (TOS). I’ve seen several doctors and tried physical therapy over the past six months. My X-rays are normal, and I’m an otherwise healthy 33-year-old mother of three. Is there a reliable surgery that can improve my quality of daily life?

X-rays are only one of several important tests used for problems of TOS. X-rays are useful for seeing whether symptoms are coming from a cervical rib. In addition to standard X-rays, doctors perform clinical tests to help sort out where the symptoms are coming from. To help confirm the diagnosis, other special tests, such as a venogram or ultrasound, may be used.

Expert surgeons who deal with TOS perform various types of surgery with good results, especially when they are certain the symptoms are from TOS and not from some other cause. Before going ahead with surgery, most surgeons will prescribe up to 12 weeks of nonsurgical treatment to see if the problem can first be corrected without surgery.