@snowmass You can still continue your PT and add MFR. That will not interfere. MFR is like kneading bread dough, like a massage where the therapist pushes against the barrier (tightness) and just holds that shearing pressure waiting for a release. I get muscular headaches on the back of my head usually one sided from TOS on the side that is tighter. It has taken me a long time to realize that the slight rotation of vertebrae caused by the muscles spasms from TOS is causing that pain when it stretches muscles on one side and they complain. I have had it rotate C1 & C2 and even all the levels including my fused C5/C6. Botox injections are supposed to temporarily paralyze the muscle spasms. I think having cervical disc issues is also adding to the problem as it did for me. Since my cervical C5/C6 fusion, the muscle spasms have calmed down, but the can happen if I sleep wrong with my neck in a bent position or fall asleep siting up. I continue to maintain with stretching and MFR work I can do on my own. You have nothing to loose in trying MFR. You don't need to get a further diagnosis on TOS to try MFR. Just being in pain is enough to warrant physical therapy, and the MFR therapist has to code this along with other modalities that the insurance company accepts. Sometimes they will not just pay for MFR as just a manual therapy. My experience is that overuse of muscles kicks up TOS and causes pain, and stretching out the tight fascia relieves pain and restores better movement. You won't know if it helps you unless you try it. Stress also increases issues with TOS. That is something you can't always change, but I try to not let things bother me. (Easier said than done.) That means I have to step away from relatives who are difficult people. Doctors understand that this is something that exacerbates TOS.

Think of it this way. You have tightness in your neck as if you have a bunch of rubber bands pulling on your neck (muscles), and it can easily get just a bit out of perfect alignment and get stuck like that. MFR loosens those rubber bands and allows the vertebrae to get into better alignment. Because of yard work I was doing recently, a couple of vertebrae were locked in a not so good position and I had numbness on the side of my arm until I worked on it with my stretches and massaging the muscles. The facet joints on both sides clicked as it got realigned and the pain stopped. It took a few days of my working on it to relieve it completely. I feel the tenderness of muscle pain into my scapula, in the SCM muscles that turn my head, and muscles that support the cervical spine as well as aching down my arms. Because I'm on Medicare now, and they limit how much PT a person can have, I have to do more on my own, and see my PT when I can't resolve my own issues. It was better when I could see her more often. My PT advises to avoid surgery for TOS. My hands used to turn blue/purple and get cold. That doesn't happen anymore. It's also better now that I don't work at a stressful desk job on a computer anymore. Some of your arm pain could be coming from your cervical stenosis and it's difficult to tell where most of the pain is coming from or if it comes from multiple areas.

Are you seeking a surgeon for TOS or cervical disks or both? How long have you been in physical therapy?