Poor posture can also be the cause of your problem. Also, check for overall tension in your upper body when you are doing everyday tasks. A lot of people subconsciously raise their shoulders for no reason. I understand your concerns with not wanting surgery. I don't know where you are located cut make sure you have an experienced doctor, probably a vascular surgeon. I know there are some posts where a lot of pod doctors are listed so hopefully you will be able to see one of them. Be thankful that your issues are not neurogenic. My thoughts are with you.