You might need to start with even less tilt, sounds like a lot of sx showed up @50.
Maybe 30 and see how that goes..
Less tilt and use the Infrared??

I have one and found that it really depends on the day for me. I do not let my arms hang overhead, I kind of lock them to my sides. You really need to start of with less of an angle. Even a slight angle is causing decompression of the spine. I started only at 10 degrees and did that for over a month before increasing it to 20. I can and have in the past did complete inversion, and it really depends on the day for me whether or not it causes me problems, kind of just like any other activity with TOS.

Thanks for everyone's advice.

Session 2:

I used a timer to keep it to 1 minute which was pretty short. I now think I was on 2 - 3 mins last night for my first session. Woops.

I did my normal stretch routine just before going on. Once on, I found that I'm still tight in the abs and neck (no surprise), but not as much as last night. I felt some stretch in my top right thigh and also my lower center back, close to the hips.

I was at 45 degrees. I let the arms hang, but they go down further because they are outside the backing board. It's a little like the stretch we do when we arch over an inflatable ball, foam roller or yoga bolster. But more extreme. I can still feel it in my left chest.

No dark red hands and purple finger tips this time.

I think I'm okay with 45 degrees and a true cap of 1 minute. I'll do it again tonight and then based on feel, I will increase the time at some point.

I still debate on letting the arms go or holding them up.

It's been a full week now.

On my 3rd, 4th and 5th sessions I came out of the inversion with a distinct sensation of being more symmetrical and taller in my trunk. It's a neat feeling.

I'm doing 3 sessions per day at 45 degrees. Today I did 4 mins, 5 mins and 5 mins.

I don't feel a big change in symmetry and height now at the end of each session, but I do feel a difference in these aspects throughout my day compared to how I was before I started inversion. I used to feel like my trunk kind of collapsed in on itself, but having already done stretches, exercises, PT and chiro, I didn't really know what to do about it. Well I eventually did... I thought inversion might help and that appears to be the case.

I always use the timer to make sure I'm controlling the duration.

I use the infrared heat now. Once I'm stretched out, it doesn't really hit the upper back which is disappointing, but I still like the feature and I'm glad I got it.

My abs have loosened up allowing other parts to stretch or at least for me to feel them stretching. The next body part to kick in was the lower spine, a place where I don't normally feel much sensation. After that loosened up, I am now feeling it in my ribs. What will be next, I wonder?

The front neck is still tight and grumpy.

So in addition to getting spinal decompression, this is also a great passive muscle stretch for tightwads like me.

My lower and mid back pain have greatly reduced. And on the one day they acted up, I got on the inversion table for just 4 mins and that knocked it out. Sweet!

Only downside so far is that when I come back up, I often feel some dizziness and it can last from a few mins to 20 mins. I don't like it.

I'm comfortable now with letting the arms hang, though I get some minor symptoms.

If I had to do it over again, I would start at 30 degrees instead of 45.

I wish I had started inversion sooner. On the other hand, I was a train wreck in 2011 and this may have been too intense for me. If that's where you are at, start with 10 degrees like brmr19 did and don't neglect your other treatments.

Tomorrow I will do three sessions of 5 mins each. As long I'm making progress at 45 degrees, I'll just leave it there. I can increment it when I start plateauing.

I've been able to substantially cut down on the dizziness by adjusting my first rib. Adjustment techniques have been discussed elsewhere on these forums. You can search here, on google and youtube if you need more info.

I'm doing 3 sessions per day, 5 mins each. Yesterday I adjusted the angle to be a little deeper.

I have fewer symptoms all around, whether it's back pain or TOS, but it's a bit early to declare victory. Today is day 10.

I'm at about 60 degrees now, 6 minutes, 3 X per day. When I'm inverted, I feel stretching throughout my torso, waist muscles, back, ribs and neck.

This is the first angle that has given me elongation and loosening of the neck. Also, I seem to be getting less severe muscle spasms in my neck and ribs. My scm is less tight than before.

I can't really tell if the neck improvements are from the muscles being stretched, or from the pressure being taken off the nerves that enervate them. Or both. I guess it doesn't matter.

I was in better overall shape for my chiro appointment with regards to my neck and first rib. Also my pec minor was the best he's ever seen it (he does soft tissue work). My inversion is not at a full 90 degrees so my arms hang back relative to my body and my pec minors get stretched.

I still got some back pain the other day. My improvements so far are not 100%. I have all the same stuff, just dialed down.

The experiment continues, but so far, so good. It's been about 15 days.