@cjfutrell Your best bet is to find a TOS specialist for an evaluation. Look at the websites of the medical centers you are considering and see if they list TOS as a condition that they treat. When I came to Mayo for spine surgery 4 years ago, they re-confirmed my TOS diagnosis. The neurologist listened to my pulse in my neck and had me turn my head which causes the pulse to be diminished. They also evaluated me in the vascular lab and put tiny blood pressure cuffs on each finger as well as my arm, and then moved my arm into a raised position. That also cuts off he blood supply. I have also had Doppler studies where they did the same thing and confirmed the circulation was affected with arm position and/or head turning. If you look at a side view of yourself in a mirror, you might find that your shoulders are forward instead of staying inline with your body. TOS tightens the front of the chest and pulls the shoulder blades out to the side and forward. You should be able to squeeze your shoulder blades together on your back. If you can't, that needs some evaluation. The hard thing about this is finding doctors who understand it and there are a few different types of TOS and different compression points that affect nerves and circulation. You might also ask for a physical therapy evaluation, but first look for a PT who is knowledgeble with TOS. That might help further your progress. A neurologist told me that TOS is usually glossed over in med school and doctors think it is rare. It's not rare, but what is rare is finding a doctor who understands it. Myofascial release helps me a lot, and my PT also used a Dolphin Neurostim device on me which helped a lot. What happens with muscle spasms is that they hold a charge that keeps the muscle in a knot, and if you can neutralize that charge, it can release. We did MFR stretching while using the neurostim current on the same spot and it made a big difference. Dry needling also works this way, but I'm not a fan of needles, so I have been hesitant to try that.