You have pain going down your arm and you’re convinced you have a pinched nerve! What if I tell you that there is a good chance there is no pinched nerve in your neck and shoulder?At least, not the way you may be imagining it to be?
Since pinch nerve has imposters and there are other things that may give the impression that you have a pinched nerve, you may want to also read my blog: What is a Pinched Nerve.
Can a Pinched Nerve in the Neck Cause Shoulder Pain?
There are many musculoskeletal issues that can result in pain from the neck to the shoulder and down the arm, but unless the pain is following a specific nerve distribution, shown in the picture below, then what you’re experiencing is probably not due to a pinched nerve.
Now you’re wondering if a pinched nerve is not causing your pain, then what is? You have layers and layers of muscles in your neck and surrounding your shoulder complex. When muscles are put through prolonged stress and misuse, you can develop what is called trigger points.
As explained in my blog: What is the Difference Between Referred Pain and Radiating Pain? A trigger point produces referred pain, or pain in a region other than the muscle that the trigger point is in which is very different from radiating pain.
Specifically dealing with the neck and shoulder, muscles that often contain trigger points are:
- Scalene muscles
- Sternocleidomastoid (SCM)
- Levator Scapulae
- Serratus Anterior
- Pectoralis Minor
Your shoulder joint is comprised of the socket which is from the shoulder blade, the collar bone, and the actual ‘ball’ part of the arm bone called Humerus. Now the other end of the collar bone is connected to your sternum- the chest bone and there are many muscles from the head and neck that are connected to the collar bone. With something as simple as looking down at your digital devices or sitting behind the computer over time, with the neck going forward and the front of the neck muscles overworking and staying short, it is very easy to end up with trigger points that make you think you have pinched nerves. A large number of patients visiting my clinic have this very systematic decline of their posture and muscular overuse.
What Causes Pinched Nerve in Neck and Shoulder?
A true pinched nerve is caused by a space-occupying lesion compressing the nerve. This can be a tumor, cyst, bone spur, stenosis (narrowing of the hole the nerve exits through), and other cases in which the nerve is being directly pressed against. As I said before, if one of these is the cause of your symptoms, then the nerve pain would follow the specific nerve distribution as shown in the diagram above.
The more likely cause of your symptoms would be:
- Bad Posture
- Poor Ergonomics
- Excessive digital device use
- And overall Dysfunctional Movement
How Does Dysfunctional Movement Cause Pinched Nerve Symptoms?
All babies are born with the same developmental movement patterns and muscle activity regardless of the many differences they may have. That is because we are programmed to do it that way; after all, we don’t see babies learn it from anyone or go to the gym to work those muscles out. We are born to move functionally! Dysfunction comes into the picture when we require our bodies to unnaturally sit for 8+ hours every day, stare down at a computer or phone screen, or play one-sided sports (all of which are starting at younger and younger ages) to name a few. Dysfunctions happen with injuries where the body recovers, perhaps physical therapy is done but only to the area of injury and not coordinating the recovered movement with the rest of the body!
With our lifestyle factors our brain, which is in charge of every function in the body, is forced to re-route how we move based on the demands we give. Now with every dysfunctional movement, comes small repetitive damage, because your muscles and joints are functioning in a way they are not designed to.
A great example of this is the rolled forward shoulder posture. This is a posture in which the humerus (arm bone) sits too far forward in the socket. This means every time the arm has to move within the socket, the front gets irritated but not necessarily causing pain. The micro-damage starts and you simply don’t know it. You may think you just have a poor posture but there is more to it than meets the eye.
How to Treat Pinched Nerve in Neck and Shoulder
Trigger points occur in the muscle tissue, which means that the first stage of treatment will typically include functional rehabilitation to relieve the symptoms and restore range of motion. The best treatment choice I find is Active Release Technique (ART). ART requires moving the body part, using the right muscle whose primary task is that movement which applying pressure strategically over the area where the muscle is most restricted. This produces a much-needed increase in the range of movement which is necessary to effectively address the dysfunctional movement.
Dysfunctional movement treatment has two parts. The dysfunctional body part that is involved in the movement that needs to work with the rest of the body and the brain part of the movement equation. The mistake is made when we only address the body part, not its cooperation in movement with the rest of the body, and then the correction of the brain’s blueprint of movement.
If movement was a concert, the brain would be the concert conductor, the blueprint map (read about this blueprint here) would be equivalent to the musical note in front of the brain, and the body parts would be the musicians. You may think the pianist is not performing well but the pianist is performing to the best of its’ ability given the whole group is off; alternatively, the pianist may be playing poorly because the piano is not tuned. Now that you have assessed the problem, the whole symphony needs to do practice to bring the concert performance up to par. Do you see how everything is connected (you already knew that) but to a much deeper level than most treatments are designed? (that is where treatments fail). What I just talked about is Postural Neurology and Developmental Kinesiology, the pillars of my practice.
The exercise below is a great example of these two concepts used in an exercise addressing both the neck and shoulder.
My blog 3 Must Do’s in the Treatment Of Pinched Nerve will also discuss how Ergonomics are involved and what you need to do to address your work space ergonomics. Use my Ergonomic Checklist to make the necessary adjustments to avoid neck and shoulder pinched nerve symptoms.
How to Sleep When Having Pinched Nerve in Neck and Shoulder
My blog, Is the Way You’re Sleeping Causing You Pain? explains how your sleeping position can cause more issues than a sore neck. Watch the video below to see how. If you are still unsure about your pain down the arm, contact me anytime.