Hi,My name is Lisa and two years ago I was involved in an accident that has developed into TOS. My symptoms are weakness in the arms, headaches, and severe pain in my shoulders. the vascular surgeon has told me that both shoulders will need to have a rib removed and a scalpectomy perfomed. He also said that because of the way my shoulders a formed that because of the trama of the accident it has compressed the muscles and cuts off the circulation when my arms are being used. Hope this helps.