As one of the most complex joints in the body, it’s common for the shoulders to be a source of pain. In addition to common shoulder injuries, the area can also suffer from conditions like tendinitis and arthritis. One issue that is often at the root of shoulder pain is cervical radiculopathy, also known as a pinched nerve in the upper spine. This can come from gradual changes in the body over time or from a sudden trauma like a car accident and will typically not be relieved until the pinched nerve has been properly released.
What Is a Pinched Nerve and What Causes It?
The term pinched nerve refers to a condition in which any nerve is compressed, usually as a result of surrounding tissues placing pressure on the nerve. A simple example is the feeling of your foot “falling asleep” when your legs have been crossed for too long- the tingling “pins and needles” feeling this causes is a temporary version of a pinched nerve. With the nerve under pressure, it cannot properly carry signals down your extremities, leading to this feeling.
Unlike this common scenario, a more serious pinched nerve can become permanent and cause serious issues without treatment. This can occur in any part of the body, with effects differing based on where in the spine the pinched nerve sits. The lumbar spine, or lower back, may lead to issues in the legs and feet, while the cervical spine or upper back is linked to pinched nerves in the shoulder. Conditions like carpal tunnel and ulnar neuropathy are common examples of pinched nerves that impact the hands.
A pinched nerve in the shoulder happens when bodily material puts pressure onto a nerve that extends from the spinal column toward the neck and shoulder. This material can be bone, disc protrusions, or swollen tissue.
The cause of this condition can vary and be related to aging or a specific acute injury. The most common causes are:
- Disc degeneration: As we age, the gel-like discs that sit between our vertebrae begin to break down, reducing their ability to absorb shock and separate the bones. If they degenerate enough, the bones can begin to rub against each other and the surrounding nerves, causing pain. In serious cases, bony growths called bone spurs can develop on the vertebrae and impact these nerves as well.
- Herniated discs: The discs in the spine can become herniated well before they are worn down, leading to the disc and its contents sticking out into the spinal column. This can crowd out the nerves that sit there, causing pain that is worsened during particular activities.
- Acute injuries: Any trauma, like sports or car accident injuries, can cause a disc to become herniated or tissue to become inflamed, leading to pressure on the nerves.
Certain health conditions and circumstances can be risk factors for pinched nerves. Some examples include:
- Rheumatoid arthritis, which causes inflammation in the joints that can pressure nearby nerves
- Diabetes, as high blood sugar has been associated with nerve damage known as diabetic neuropathy
- Obesity can lead to additional strain on internal tissues, which causes inflammation
- Pregnancy’s hormone changes can also cause tissue to swell and compress nerves
Avoiding Pinched Nerves
Before suffering from a pinched nerve, there are a number of steps someone can take to avoid the issue, especially if you know you are at an elevated risk of the condition. Most of these will focus on maintaining good health and spinal alignment, as well as some lifestyle adjustments.
If you participate in any physical activity, proper stretching is crucial to avoid injuries or instances where your discs move unexpectedly. Keep all activity within your abilities, ramping up slowly rather than suddenly increasing the intensity of a workout. It can even be helpful to use certain splints and braces during a workout to help the body maintain alignment.
Focusing on posture outside of working out is also a great prevention method when it comes to pinched nerves. Setting up an ergonomic workspace helps most people, especially those who often look at screens and may slouch over the course of the day. Sleep posture is also important to the shoulders and neck, as an odd position or lack of spine neutrality can place additional pressure on the cervical spine.
Maintaining a healthy weight to avoid additional strain and focusing on avoiding foods that cause inflammation can also be helpful in avoiding pinched nerves in the future.
Signs of a Pinched Nerve in the Shoulder
The most likely symptoms of a pinched nerve will include shoulder pain, numbness, and general discomfort in the shoulder region. Less commonly, you may experience symptoms such as:
- Changes in sensation and feeling on the side of your shoulder pain
- Muscle weakness in the arm, hand, or shoulder
- Neck pain that is worse when turning the head side to side
- Numbness and tingling in the fingers and hands
A pinched nerve usually affects only one side of the body, so symptoms that spread down the arm and hand will be on the same side as the shoulder that is impacted.
When to See a Doctor
Some people will advise that pinched nerves usually resolve themselves over time. It is true that symptoms often fade, but any underlying condition must be addressed through proper treatment in order to prevent it from coming back or worsening. It is important to seek medical help because pinched nerves that are left untreated can cause more complications like chronic pain, sciatica, or worse. You can manage the early and intense pain of a pinched shoulder on your own but should always seek professional care to help prevent future issues.
If pain is severe, constant, or has returned frequently, this can warrant attention. You should seek immediate care if your pinched nerve is affecting your bowel or bladder, causing a whole limb to be weak or give out, stopping you from grasping things, or causing you to drop things frequently.
It is also important to seek immediate care if you suffer an injury or a traumatic event that could have caused a pinched nerve.
Diagnosing Shoulder Pain
When you visit a doctor and describe symptoms of a pinched nerve, they will first do a thorough physical examination of the neck and shoulder to help diagnose the problem. Many symptoms of pinched nerves can also be related to other injuries, so it is important they rule these out and identify the pinched nerve as the cause.
During a physical exam, your doctor will test reflexes, sensations, and strength in the side of your body where the symptoms are presenting. This can include having you perform certain stretches and exercises and sharing what helps or worsens your symptoms. As diagnosis can hinge on this, it’s important to always be honest and upfront about your pain.
A skilled specialist may be able to identify which nerve has been pinched through this process, but often imaging tests like x-rays and MRIs will be necessary to determine this. X-rays create images of the bones, but not the nerves; however, they can identify root causes of pinched nerves such as narrowing in the vertebrae gaps and bone spurs.
An MRI provides more detailed information, including images of the nerves and discs that give insight into their overall health. These scans can also rule out or identify issues like arthritis and injuries to the bones that could be at the root cause of the pinched nerve.
Managing a Pinched Nerve in the Shoulder
Shoulder pain should always be seen by a skilled doctor who can help understand the root cause of the issue and work towards a resolution. It is common for a pinched nerve to “flare up” between periods of no symptoms, but the problem is still present without proper treatment. However, treatment can take time, and in order to manage pain and other effects of the pinched nerve, there are home remedies that can offer relief.
During periods of intense symptoms, try the following:
- Sleep with a pillow that offers a lot of neck support or one specifically designed to take pressure off the shoulders.
- Use sparing amounts of anti-inflammatory medications, like Tylenol.
- Wrap an ice pack in cloth or towels, applying to the neck and shoulder blade areas during the first 48 hours of symptoms. After that period, switch to warm, moist heat.
As symptoms wane, there are other steps that can help avoid more episodes of intense pain, such as:
- Engage in regular low-impact exercise to reduce stiffness and maintain a healthy weight.
- Use massage to boost circulation in inflamed areas. This will relieve muscle tension and promote healing.
- Focus on using proper posture when sleeping and sitting, especially at a desk. Ensure any screens are set up to be eye level and your seating is ergonomic to avoid “tech neck” and further strain.
- Use yoga and other methods to incorporate gentle stretching into your routine.
Treatment for Pinched Shoulder Nerves
While it is common for pain from a pinched nerve to resolve on its own, it will usually return in a short period when the root cause is not addressed. Injuries may cause misalignments or the discs may continue to become weaker, leading to worsening symptoms over time. Proper treatment for the pinched nerve will vary based on multiple factors, primarily what is causing the issue in the first place.
Doctors typically recommend non-invasive options, including home management of pain, as the first version of treatment. These treatments may include:
- Over the counter anti-inflammatory medications like ibuprofen
- Oral corticosteroids to relieve inflammation
- Injections of corticosteroids to reduce swelling and inflammation
- Wearing a soft cervical collar in order to limit movement in the neck and allow nerve damage to heal
- Physical therapy designed to reduce stiffness and improve range of motion
- Prescription pain relief used for short periods, allowing for less pain and better movement of the shoulder
If a degenerative condition is at the root of the pain, it may worsen over time despite these options. When a pinched nerve does not improve with less invasive treatment options, surgery may be discussed. The type of surgery will also vary based on the exact issue.
Common surgeries used to treat pinched nerves include:
- Anterior cervical discectomy and fusion, or ACDF: This procedure involves a surgeon accessing the neck bones through an incision in the front of the neck. They will then remove any areas of the disc or bone that is causing pain. The area of the spine that is affected will then be fused together.
- Artificial disc replacement: If a disc is diseased or damaged, it can be removed and replaced with a new one. These artificial discs can be made from metal, plastic, or a combination of both. The procedure is done by accessing the spinal column through an incision in the front of the neck.
- Posterior cervical laminoforaminotomy: A surgeon will make a 1- to 2-inch cut in the back of the neck before removing any portions of the spine that are pressing on nerves.
- Decompression of the suprascapular nerve: The goal of this procedure is for the surgeon to free up the nerve in the region of the scapular notch when it becomes compressed.
The procedure used will vary depending upon the person’s symptoms and what area of the spine and tissue are being impacted. After surgery has been performed, physical therapy and other services will be recommended to help regain strength and flexibility and adjust to any major changes in the spine’s composition.
Experienced doctors will work with you to avoid surgical options and release pinched nerves on their own whenever possible. At AICA College Park, our team is dedicated to creating an individualized treatment plan for each patient with the goal of relief and a return to normal daily activities. With chiropractors, physical therapists, neurologists, orthopedists, pain management experts, and more in our office, AICA College Park offers a holistic view of your pinched nerve and an integrated approach to your care. We even have on-site radiologists and diagnostic imaging to help make your experience seamless. Contact us today for your initial evaluation to begin creating a plan.