I've been diagnosed with bilateral thoracic outlet syndrome. i often wake during the night with excruciating pain in both of my hands, arms and shoulders. my question is, what can i do to help relieve it right then? pt only made it worse. thank you?

If indeed the diagnosis is accurate, you should consult with an experienced vascular surgeon, as a last resort intervention might indeed be surgical (excellent surgeons are scattered about the country). Re. "right then", avoid elevating arms above chest level and monitor posture at night. PT can work if the therapist has experience with brachial plexus therapy (not so common). ?virtual consult?