Get other opinions even if you pay cash. I've had this for 4.5 years and my life & career have been destroyed. I have paid for private consults and over 20 physicians agree on my diagnoses, but finding one to tackle it has been hard because my case is very complex. TOS cases aren't always uniquely neurogenic, arterial or vascular and may have a combination of symptoms. Weights aren't usually good because muscle tension and fibrosis tend to exist, and it becomes a cycle of posturing problems. Discomfort makes you assume unnatural positions, which further aggravates it. Get any tests you can out of the way and find the most experienced surgeon possible. Then ask for contact info of former patients with the same diagnosis who have had good outcomes to ask about it. I had one horrid surgery to stabilize my scapula and am praying for the scalenectomy and rib resection. Scary as hell, yes, but not as scary as watching your life dissolve while you rot waiting for insurers to pay up. You aren't alone, though. Be aggressive and seek solutions. read every journal and text you can get your hands on. Educate yourself. Watch for RSD and CRS. note: Raynaud's -type symptoms can occur with TOS (phenomena and syndrome are not the same). Imaging doesn't always show anything positive. Scalene blocks might give insight. Botox may help temporarily. EMG testing. Imaging with contrast. Venogram. Ultrasound. Evoked potentials. Hand Blanches? Volumetric studies of the hands. Temperatures of each digit. Photograph changes in good light. The fact it's in your toes, too, sounds more like Raynaud's Syndrome. look up R. Sanders - Denver / R. Thompson - st louis / R. Braun (San diego) / J. Brown (san diego) / Collier? / Gelabert -UCLA / Warner / Best of luck. I'll need some, too. If you get depressed, get help. Pain is a killer