The neck is a complex place when it comes to nerves, and neck pain can stem from all manner of things, including a pinched nerve in the shoulder. Nerves can become trapped in the shoulder itself, due to the cramped conditions in an area called the brachial plexus. The brachial plexus has a number of cervical nerves travelling through it to the upper limbs. These nerves exit the spinal column and then branch off and rejoin in various patterns to innervate the musculature of the chest, shoulder, arms, and hands. Disc herniation in the cervical spine can also cause pinched nerves leading to shoulder and neck pain.
Pinched Nerve in Shoulder Causes
If you have an extra ‘cervical’ rib this can put more stress on an already cramped area, and any minor trauma to the shoulder can result in neck pain, arm pain, and even coldness and weakness in the fingers, depending on which nerves have been impacted. Sometimes a fairly innocuous repetitive motion which taps on the front of the shoulder can lead to inflammation in the area and cause a pinched nerve in the shoulder.
Brachial Plexus Sports Injuries
In extreme cases, such as when somebody falls or has a contact sports injury (like in a football game where you might suffer a burner/stinger), the nerves may actually be wrenched out of the cervical spine, or severed somewhere in the shoulder. Damage to the cervical spinal nerves may result in pain, radiculopathy, paraesthesia, weakness, numbness, and paralysis of the upper body. If they are cut in the shoulder then they may be able to heal, be stitched back together, or have a nerve graft put in place to bridge the gap. If they are damaged at the spinal cord itself then the effect will usually be permanent.
Spinal Nerve Regrowth
Nerve regrowth takes an awfully long time, with most nerves growing at a rate of about 1mm/d, although this varies wildly. The first 72hrs after a nerve injury are crucial as this is the time period where distal nerves can,in most cases, still be stimulated. In most nerve trauma the degeneration of axons begins in the first 12-48hrs, and myelin starts to retract at this time. From 48-72hrs the axons start to break into twisted fragments, and most of the axon is lost two weeks after an injury.
Pinched Shoulder Nerves and Neck Nerves
Although muscles, tendons, bones, and cartilage in the shoulder can cause the nerves to become trapped or pinched, the majority of shoulder and neck pain is actually due to the trapping of a nerve at C6 or C7 in the neck itself. These cervical nerves travel across the shoulder blades and pathology of the nerves can lead to muscle cramps and spasms. Trauma to the cervical nerves responsible for innervating the neck, shoulders, thyroid, teeth, tonsils, nose, vocal cords, outer ear, amongst other tissues, can occur due to spinal stenosis, whiplash, or disc herniation.
Pinched Nerve in Shoulder Symptoms
In the majority of cases a pinched nerve in the neck happens at C6 or C7, and your physician will isolate the problem by assessing your symptoms and then, most often, sending you for an X-Ray, MRI or CT scan. If the nerve at C5 is pinched, however, you are likely to develop shoulder pain, numbness, and weakness in the deltoids and bicep muscles. Pain can be both sharp and acute, or a dull aching pain in the neck or shoulder. Some patients may experience a widespread pain, whereas for others it is isolated to a smaller spot and can produce a burning sensation. Numbness, and a feeling of pins and needles in the shoulder can indicate a trapped nerve and lead to muscle weakness and, over time, muscle atrophy (wasting).
Pinched Nerve in Shoulder Treatment
Your sensation of pain may be more acute when trying to raise your arm above your head as this stretches the nerves and can put extra pressure on them. Over time, you may stop using the arm as much and the growth of fatty tissue around the nerves and muscles may cause difficulty in rehabilitating the shoulder and arm at a later date. Epidural steroid injections to relieve the pain and inflammation may be required to enable you to move the arm more freely and conduct physical therapy exercises to aid repair and healing. Nerves also give us our sensations of heat and cold, and any disruption to these signals can lead to a literal cold shoulder! If you have shoulder pain and a discernible temperature difference between one shoulder and the other then getting evaluated by your doctor is essential as a pinched nerve may lead to permanent damage and impairment.
Quick Tips to Treat a Painful Shoulder
1. Apply ice – this can relieve inflammation and prevent further injury to the nerve. Heat may actually exacerbate a problem, causing increased blood-flow and oedema.
2. Devise a physical therapy regime that is appropriate to the injury. Some good exercises for pinched nerves in the neck may help to relieve the pain. Talk to your doctor before conducting these in order to avoid the possibility of worsening your injury.
3. Correct your posture and maintain it! A daily regime of gentle stretching and strengthening neck exercises can really help you avoid potential injuries, neck pain, and shoulder pain. Checking your posture when at work and taking a break every half hour to stand and stretch, or even just squeeze your shoulder blades together can relieve muscle tension and make you more aware of any undue stresses and strains.