I Have An Extra Rib & It Sucks
So as the title suggests, I have an extra rib that sits just above my normal set of ribs near my neck (if this is confusing look at the picture). Apparently only 0.2% of the population has a cervical rib. I'm so special, and I feel it everyday!
Some Background
TOS or Thoracic Outlet Syndrome is something you may or may not have ever heard of. Generally, it can cause varying levels of pain due to nerve and vein compression. It can also be a wonderful catalyst for blood clots (fun!). The most common ways of getting TOS are:
- Repeated overhead motions
- Weightlifting
- Neck Tumours
- Car Accidents
- A Cervical Rib
But, if you're an overachiever like me you'll both have a cervical rib and also have been in a car accident.
There's different versions of TOS and each version comes with it's own package of fun extras.
- Neurogenic TOS - Effects the nerves
- Nerves control muscles and carry sensations from your body to your brain.
- Venous TOS - Effects the veins
- Veins carry oxygen-poor blood back to the heart (except pulmonary vessels).
- Arterial TOS - Effects the arteries and veins
- Arteries carry oxygen-rich blood away from the heart to the body
However, from my experience having both venous TOS (left side) and arterial TOS (right side) — both can cause a lot of nerve pain and tend to cease up or effect other muscles in the area.
WTF is a Thoracic Outlet???
You might still be wondering though "What's a thoracic outlet?". I like to think of it as an underground utility tunnel.
Where I live, we have more compact versions of these buried underground with a little plastic cover overtop. They can feature power lines, water lines, sewage lines, gas lines and fiberoptic internet cables. So... pretty important stuff. Likewise, the thoracic outlet/inlet contains bundles of nerves, blood vessels, arteries and lymph nodes and it's packed in pretty tightly too.
As you could imagine, when that area gets more compressed by an extra rib or through the other means I listed above bad things can start to happen. Honestly, it's amazing to me that the body can accommodate this at all.
How Bad Could It Be?
For me, it's not great but I realize it's also not the worst it could be and my situation is a bit more unique than most. I've always had an extra rib, sure — but I think it was the car accident that made things more noticeably painful initially. For two years previous to that accident I threw 40lb boxes of wine over my head for a part time job at a wine store where I did a lot of stocking and receiving of shipments. Then after that job I started working for an agency where I would sit for hours anxious and stressed out, all muscles tensed at my desk doing marketing/design work. This definitely didn't help things, but at that time I just thought the pain was 'normal' for what I was doing.
After a mild bout of COVID during the second wave, Long COVID decided to stick around and tuned up my nervous system. It caused increased inflammation, fatigue and additional joint and neck pain, so much so that I visited my Doctor several times and was finally diagnosed with tall cell papillary thyroid carcinoma (thyroid cancer). The first surgery was not entirely successful so a second surgery two months later extended my need for weird upright sleeping positions that were required for recovery. To aid in my recovery I did a lot of physio and neck stretches but the scarring it caused probably didn't help the still undiagnosed TOS near that area.
What Now?
About a year after the thyroid cancer stuff was done with (2024) I continued to push my Doctors on the matter of my pain and finally saw the only specialist in my province to get a proper diagnosis. At the TOS clinic we started with shots, and we're still seeing how that plan plays out in the short term but surgery is now on the table if I would prefer a potential "long term fix". It's not a sure thing of course, and there is a very low risk of side effects that range from nerve aggravation to breathing problems and potential lymphatic draining issues. I'm still taking it under consideration though.
Physio, nerve glides, stretches, hot packs and pain meds keep things under control but I'm constantly battling my TOS, and it can be very exhausting at times. Although my case may seem bad, it can actually get much worse for some. I've been lucky not to get any blood clots or serious nerve issues so far since my compression is more specific to body positioning. Pain, cold extremities and feelings of compression are really my only symptoms.
I'm writing all this to really just get all this information out of my head, these past several years 2022-2025 have been very heavy on my body and soul. I hope some of this info might help those experiencing similar issues or going through a tough time themselves.
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