ES symptoms seem to come on “over night” i.e. you’re fine one day & in pain the next & there can be no specific reason for the pain onset. I’ve been curious myself how it goes from 0% -100% pain so quickly. It’s possible that the calcification or vascular compression are present at some level then hit “critical mass” at some point & then the pain starts. There is much we don’t know about the human body & about ES so we have to speculate, as you’re doing, about how & why we end up w/ the physical problems we do.
Have you read any of @Algobe’s posts? He’s having surgery in Spain next year in April with Dr. Bernal Sprekelsen. It sounds like Dr. Sprekelsen does the intraoral approach which isn’t ideal for vES, but it still might be worthwhile getting an opinion about your situation from him.