Shoulder Pain and a Pinched Nerve
A pinched nerve in the shoulder can happen when a nerve coming from the neck is irritated or ‘pressed’ on by a misaligned vertebra. This can also lead to numbness, weakness, or pins and needles in the arm and hand.
Medically, a pinched nerve in the shoulder arising from the neck may also be referred to as Cervical Radiculopathy.
An acute injury or changes to the body, such as arthritis or a misaligned vertebra, over time can cause a pinched nerve in the shoulder.
What are the symptoms?
Firstly, a pinched nerve will typically cause pain, numbness or discomfort in the neck and shoulder region. Other symptoms may include:
• A change in feeling, such as feeling the cold.
• Weakness in the arm or hand.
• Shoulder ‘drop’, where the shoulders are no longer level.
• Neck pain, especially when rotating the head or tilting from side to side (lateral flexion).
• Numbness or tingling in the fingers or hand.
• Neck tension.
• Headaches.
• Tiredness.
What are the possible causes?
The most likely cause of a pinched nerve in the shoulder is when material, such as a spinal vertebra, disc protrusion, or swollen tissue presses on the nerves leading from the neck to the shoulder.
How is the spine involved?
The spinal column is made up of 24 bones called vertebrae, with cushion-like discs between each one.
The spine is divided into three regions:
• Cervical Spine: Which are the first 7 vertebrae running from the base of the head to the beginning of your shoulder.
• Thoracic Spine: In the area in the middle of the body where the ribs attach and help make up the chest cage.
• Lumbar Spine: Are the five lowest vertebrae with the 5th lumbar vertebrae attaching from the sacrum (hips).
Common causes of pinched nerves in the shoulder include:
• Disc degeneration: With time or injury the gel-like discs between the neck vertebrae may start to wear out. As a result, the bones may start to rub against each other and the nerves. Sometimes bony growths on the vertebrae, called bone spurs, can develop, and can press on the nerves.
• Herniated discs: A disc can bulge out and press on the nerves that exit the spinal column.
• Acute injury: A person who suffers an injury, for example a car accident or sports mishap can create an injury or tissue inflammation that presses on the nerves.
Diagnosing shoulder pain
Diagnosing shoulder pain begins by taking a history and performing a physical examination.
Your chiropractor may often organise tests to confirm a diagnosis or rule out other causes. These tests include:
• X-ray or CT scan: these tests can look at the spinal bones and tissues to help identify changes that may be pressing on a nerve.
• Magnetic resonance imaging (MRI): This test provides even greater detail of soft tissue and nerves that a CT scan or X-ray cannot.
• Electrodiagnostic studies: These tests use special needles that send electrical signals to different areas of the neck and shoulder. They can test the nerve functions in the body to work out when one is compressed.
These tests can help identify a pinched nerve in the shoulder or another problem that can also cause shoulder pain.
These include:
• Tendon tears
• Types of arthritis or inflammation of the joints
• Bursitis
• Dislocations and fractures
• Developmental abnormalities
Treatment
The type of treatment will be determined after considering the following:
• What is causing the pain
• How severe the pain is
• How the pinched nerve affects daily activities
• Whether your condition will deteriorate without treatment
Treatment for pinched nerves includes:
• Using nonsteroidal anti-inflammatory drugs, such as ibuprofen
• Using corticosteroids (cortisone) for relief of chronic inflammation
• Injections of corticosteroids to reduce swelling and inflammation
• Chiropractic adjustment – hand on care will help restore movement and alignment
• Using hot/cold therapy and exercises to assist in healing and repair
• Surgery – not to be considered unless all alternatives have been tried without success
If surgery becomes an option, it may involve the following:
• Artificial disc replacement: This procedure involves replacing a diseased or damaged disc with an artificial one made from metal, plastic, or a combination of both. As with ACDF, a surgeon will access the spinal column from the front of the neck.
• Anterior cervical discectomy and fusion (ACDF): In this procedure, a surgeon accesses the neck vertebrae from the front of the neck. They remove the area of disc or bone that is causing pain. They may also fuse areas of the spine together to reduce pain.
• Decompression of the suprascapular nerve: In this case a surgeon attempts to loosen the nerve in the region of the scapular notch where the nerve is compressed.
• Posterior cervical laminoforaminotomy: This procedure involves making a 2cm to 5cm incision on the back of the neck before removing areas of the neck vertebrae that may be pressing on the nerves.
Shoulder pain management
A combination of the following may help:
• Apply ice packs to the neck and shoulder area for 15 to 20 minutes at a time and repeat every 1.5 hours.
• After 48 hours consider changing to heat. Starting with ice is to reduce inflammation, and once controlled, heat is preferable.
• Sleep with a pillow designed to support the neck.
• Use liniments and creams to assist with soft tissue pain.
• Take anti-inflammatory or pain-relieving medications.
• Consider soft tissue management with a chiropractor who can care for both the neck and affected muscles.
• Massages can boost circulation to inflamed areas, which can aid healing. They can also relieve muscle tension.
• Focus on using correct posture when sleeping, standing, and sitting. When using devices such as a hands-free phone or laptop, either stand or sit, and bring the device towards you so your head isn’t bent down for prolonged periods.
• Exercise regularly to reduce stiffness and improve mobility of your joints.
• Stand tall. Sit tall. Think tall.
Your local chiropractor is the perfect person to give advice on appropriate treatment, stretches, and postural advice. They may suggest an X-ray exam to start with to get an idea of what is going on and you can look at moving forward from there.
If you are looking for a local chiropractor in the Cannington area, we would love to help get to the reason as to why you are still in pain.
Cannington Chiro Services
Patients attending Cannington Chiro help us by first filling out a “New Patient Questionnaire”, followed by a thorough consultation, examination, and assessment. This helps us help you.
Beginning treatment ASAP is a priority to us, with the aim of, in most cases, commencing treatment from day one. Healing, repair and rehabilitating the body after being injured is a process – and processes take time – so with understanding and patience a positive long-term outcome can be expected.
We look forward to helping you and demonstrating that we may be the missing link in your recovery.
