You’re feeling numbness, tingling, or shooting pain in your back area and assume you
have a pinched nerve in your shoulder blade. Having been in practice for over two decades, I can confidently say that what you’re experiencing is likely due to what is called a trigger point.
Trigger points are lactic acid buildup in a muscle due to voluntary or involuntary contraction of the muscle. Involuntary is when for instance you are slouching as you read this blog and you happen to have that posture most of the time because your job entails looking at digital devices. If that is the case, chances are your neck is forward, you are tensing the top of your shoulders and mousing so much that your arm muscles are tense in certain groups while another group is fully being ignored. You are re-wiring your movement patterns from what you were designed to do (biological patterns of movement and use) to a dysfunctional state (pathological patterns of movement).
For the purposes of this blog, we will continue to use the term “pinched nerve in shoulder blade” when discussing causes and treatment of numbness, tingling, and shooting pain in the shoulder blade area.
Pinched Nerve in Shoulder Blade Symptoms
Contrary to what you may think, not all numbness, tingling, or shooting pain is due to a nerve issue, but an imposter! By imposter, I mean trigger point! According to an AFP Journal, “Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders.”
This means that the location of your symptoms is not necessarily where the trigger point is located. You can read all about referred pain and trigger points at this blog I wrote on, What is the Difference Between Referred Pain and Radiating Pain?
Trigger points can become so painful resulting in a decrease in range of motion, even at a joint away from where the trigger point is located. In this case, the scapula, or shoulder blade, meets with the head of the humerus (your arm) and is layered with many ligaments, muscles, and soft tissues that make up the shoulder complex. Also, you can’t dismiss the role of the muscles in the arm and forearm! This ball and socket joint is heavily impacted by our lifestyle of sitting and typing or using computers quite a bit.
Given the many pieces of this joint, there are many muscles that can be the source of your pain so let’s discuss what is giving you problems. If you’ve experienced a recent trauma or injury to the area, I encourage you to get evaluated by a doctor to make sure there is no other structural damage at play here. This doctor does not need to be an orthopedist, but a chiropractor who is not all about ‘cracking your bones’ is perhaps the best doctor to consult.
What Causes Pinched Nerve in Shoulder Blade
Trigger points can occur in any muscle in the body and in the case of the shoulder blade and the surrounding area influencing it, we are talking about many smaller muscles. Affected muscles specific to the shoulder joint include:
- Infraspinatus
- Levator scapulae
- Serratus Anterior
- Trapezius
- Teres Major and Minor
- Triceps
- Biceps
- Rhomboid
- Neck extensors
- and more!
Let me put it in a story format: if movement is a concert, our brain, the master coordinator, is the concert conductor, the musical notes in front of it is the map of movement we are born with (homunculus) that gets fine-tuned the first 2 years of EVERY baby’s life; the body parts become individual musicians.
When due to injury, lifestyle and habits we modify the musical note by going from the innate functional patterns of movement to dysfunctional patterns of movement, then it should not be a surprise that the metaphoric song is different than expected. This fact is what is being missed in the treatment of all musculoskeletal conditions. We are too busy isolating the area in pain or discomfort, work that area out and then expect to see a long-term effect.
This is explained in the video below:
So in order to address the issue to the core of the problem and to not only address the cause but the feeders of the cause of the problem, we need to look at postural neurology and developmental kinesiology.
Once we can recognize the extent of the problem, then we can comfortably and methodically proceed to treat not only to get rid of pain but to address the cause and the feeders of the cause of the problem.
How to Relieve Pinched Nerve in Shoulder Blade
Functional rehabilitation modalities such as Active Release Technique (ART) to relieve pain and restore normal movement in muscles and joints seem to be the first step. This is where it’s very helpful to know and understand the proper muscle activation for specific movements!
You may read about ART to understand the mechanics behind this functional rehab. and watch the video below for something you can do at home to get some relief.
As I said before, overuse, aside from athletics, is most commonly seen in the form of bad ergonomics and technology use which also always means bad posture. Read my blog on Ergonomics and check out my recommended checklist to improve your own work environment. Every little step helps.
Pinched Nerve in Shoulder Blade Exercises
It is not enough to just get rid of the pain; you want to correct the dysfunctional movement and poor posture that has resulted. If you skip this part of treatment, you’re likely to experience the pain again.
Dysfunction means you have started using your muscles in a way they are not designed to function or you’re not using your stabilizing muscles at all, which means other muscles are forced to pick up the slack. This happens not because your brain and body are making mistakes! It happens because we are highly adaptable and if that was not the case, you would be miserable over every little deviation from how things were ‘supposed to be’.
This is very common when it comes to the shoulder because we see everyone, even children, with the rolled forward shoulder posture thanks to our increased technology use. So yes, bad posture means dysfunction!
The video below shows a great way to functionally strengthen your shoulder stabilizers, without the use of any bands or weights, because when did you ever see a baby use a band or weight to build muscles and develop movement?
This exercise and the many others are shown on my YouTube Channel, specifically those in the Functional Movement/Posture Exercises Playlist, follow the concepts of the natural development of movement. This is called Dynamic Neuromuscular Stabilization or DNS.
If we all developed movement and muscles this way, and are now dysfunctional, why reinvent the wheels? If you are interested in moving better and healthier I encourage you to visit my Website and if you still have any questions you can contact us.
Dr. Shakib