Accumulated injuries acquired in younger years really show up in middle age..
internal scar tissue/ adhesions, and possible posture changes restrictions..

I would not jump into surgery without a work up by a well known TOS surgeon..
But i would would look into less invasive options first with expert PT , chiropractors, body-workers..

things to look into... info in our sticky threads..
gentle stretching to release adhesions
Trigger points
IFC stim
low level laser