<s>[INST] Hi, I am suffering from shoulder and neck pain causing from bilateral cervical ribs. I am taking medicine like pain killers and muscle relaxing. I want to know Can I get rid off permanently from the problem causing the cervical ribs? I used to have physical exercise like pushups, sit ups ets. Will all the exercises permanently forbiddden for me? [/INST] Hi, As what I see is that your cervical ribs are leading to problems with your upper limbs a lot. There is a solution for the cervical ribs is that to get it artificially removed. As this ribs cause compression the nerves, to be precise the brachial plexus which is one of the important branch for the nerves which supplies the upper limbs.  The decision has to be taken only after the physical examination and considering other factors that is it really needed to remove it or not to touch it. Coming the therapy part, a lot of painkillers in the long run can rotten the kidneys leading to increased creatine levels which can not be of help and a matter of worry, so avoiding too many painkillers will be advised. Use hot water fermentation if it is helping you reduce the pain. You even need to figure out the muscles which need attention as there might be possibilities that some weaker muscles will be aggravating the pain as they might change the posture and leads to nerve compression. A good physical therapist should be of use to examine and advice a good exercise prescription. Please feel free to contact me with some more detailed history. For time being avoid too many push-ups. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor.  </s>