I have a business partner who is remote from me. We work from our respective homes. I was describing TOS to her which resulted in the discovery that she has TOS.

But I agree that it is fairly rare. Ancestors with a predisposition for compressed neuro-vascular structures probably did not fare well.

Although I agree with Stoxen that it is also underdiagnosed in modern society. For example, my biz partner didn't even know she had it. When I went to the ER they didn't suggest or mention it.