Is thoracic outlet syndrome permanent?

Not necessarily.: Assuming that is correct diagnosis, this can commonly be helped with physical therapy. There may be necessity to consider surgical intervention for refractory symptoms, yet that surgery is commonly successful. This is a difficult diagnosis, to come to, so I would make sure you are comfortable with how you came to this diagnosis, and if not consider another opinion.

Impressions: First, make certain that you do indeed have neurogenic TOS (proven by EMG study of brachial plexus), or vascular TOS (proven on arteriographic surveys). Feldenkreis PT can reverse about 85% of cases, and experience surgeons have well over 93% positive outcomes. Nearest expertise to you at Johns Hopkins.