I have also found manual therapy to be effective. A patient of mine is showing ulnar nerve signs and poor posture. The patient's symptoms are aggravated with mobilisation of the cervical spine but his symptoms improve week on week. Im not convinced it is TOS but similar treatment strategies still apply. I have also found static opening techniques, so holding his cervical spine in a position opening the ipsilateral side helps to relieve symptoms. I ahve not however tried mobilisation fo the first rib and wondered how effetcive people had found this?