Neck and Shoulder Pain Diagnosis

Muscle cramps and inflammation, calcification of the ligaments, bone deformation or hypertrophy, and oedema can all exert compression on the nerves in the neck and shoulder, therefore it is one of the first things physicians tend to look for when performing neck and shoulder pain diagnosis. The majority of shoulder and neck pain is due to a pinched nerve at C6 or C7 in the neck itself however, which may cause the muscles to cramp and spasm and could then lead to further nerve compression in the brachial plexus. The cervical nerves are also responsible for innervating the thyroid gland, teeth, tonsils, the outer ear, the nose, the vocal cords, and for regulating the pharynx and the epiglottis to stop the accidental aspiration of food. Where neck and shoulder pain exist alongside other problems with swallowing, breathing, or a seemingly unrelated condition concerning the neck or head it may be that the root cause is a common one. Such nerve trauma may occur due to spinal stenosis which should be recognizable on an X-Ray or MRI scan, as is disc herniation, and fracture which may also cause nerve compression.

Neck and SHoulder Pain Diagnosis

Neck and Shoulder Pain from Whiplash

Those who have suffered whiplash do not always develop symptoms straight away and may not connect the sudden onset of neck and shoulder pain with the accident. Whiplash can however compromise the connective tissue in the neck and lead to hypermobility after initial swelling has reduced, making degenerative conditions such as cervical arthritis more likely to develop. 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).

Neck and Shoulder Pain from Fibromyalgia

Where there is a suspicion of fibromyalgia the doctor may test the trigger points in different areas of the body to see if these elicit a pain response in the patient. If pain is generally worsened after alcohol consumption, relieved by exercise, and exacerbated when stress levels are high, then fibromyalgia is a likely diagnosis. A test to detect high levels of substance P in the spinal fluid may confirm the diagnosis, as can high levels of N-methyl-D-aspartate (NMDA), both of which increase a person’s sensitivity to pain. A spinal tap may reveal high levels of inflammatory substances (specific cytokines) and any neurological deficits such as developing weakness or numbness in the neck and shoulder may instead lead a physician to suspect a demyelinating disorder such as multiple sclerosis, amyotrophic lateral sclerosis, or spinal cord injury. Further tests would need to be carried out to detect any lesions in the spinal cord or brain and the presence of antibodies to myelin in the blood. These conditions are considerably less likely to be the cause of neck and shoulder pain but may be suspected if other symptoms are also present, in any case they should not be overlooked during neck and shoulder pain diagnosis.

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Last Updated: 04/15/2011