Thoracic outlet syndrome (TOS) involves pressure on the arteries or nerves running from the neck to the arm. TOS is rarely caused by an extra cervical rib. Surgery to remove the extra rib is only done when your doctor is absolutely sure it is causing the problem.
The pressure of TOS can start in at least nine different spots. It is often difficult to figure out exactly where your problem starts. That is why doctors usually recommend non-surgical treatment of TOS. You may work with a therapist to improve your posture, strength, and body mechanics to help ease the pressure. Stretching the muscles of the chest and shoulders can help. Swimming is a good exercise, as long as you avoid the backstroke and breaststroke. Non-surgical measures usually help as long as the muscles of your hand have not weakened and shrunk (atrophied) as a result of TOS.