@radar614 Yes, absolutely it can be more than one issue contributing to pain and that tends to confuse the diagnosis. If you look at teaching medical centers in your area, see if you can look up TOS on their websites. That may lead you to a specialist. You can travel to see a good specialist. The doctors that understand TOS are kind of few and far between. If you have a neurologist, they may have a suggestion. Your case is like mine with many similarities. TOS can cause pain in hands. I can get a muscle contraction on my palm on the pinky side. I have been able to bring on symptoms with my neck position. This also affects my ability to breathe properly because it tightens my chest wall and it doesn’t expand as much on one side.