Is a problem with my neck causing shoulder pain?
Discover how cervical spine injuries can lead to pain and numbness in your shoulders, arms and hands.
Have you ever tried to reach over your head only to feel a sharp, stinging pain shoot from your shoulder into your arm? When you try picking something up off the floor, do you feel stiffness in your neck and a dull ache deep in your shoulder? Does your hand sometimes feel numb or “tingly”? You might dismiss these symptoms as an overtaxed muscle, a strained ligament, or simply “feeling your age,” but there may be something deeper — and more permanent — happening in your cervical spine.
How the Cervical Spine Causes Shoulder Pain
The cervical spine (neck) connects the skull to the thoracic spine (upper back) through a series of seven vertebrae, C1 through C7, which stack on top of each other to create the top segment of the spinal column. Each of these vertebra, as well as the nerves, tendons, discs and other connective tissue protect the neck and allow it to function properly.
Take a closer look at your neck and what may be causing your pain.
When an injury or inflammation in your neck puts pressure on any nerve root in the upper spine, this can lead to radiating or referred pain in the shoulders, arms or hands. Radiating symptoms are those which travel the length of a nerve, so a problem in the neck could lead to pain, numbness and weakness in the shoulders, arms or hands. Referred symptoms are symptoms felt somewhere other than the source of the pain.
Nerve roots begin in your cervical spine and travel through your shoulder, down your arm and into your hand via the Brachial Plexus. This group of nerves controls the muscles in your shoulders, as well as your elbows, wrists and hands. Injury to or pressure on any of the nerves in the Brachial Plexus can lead to radiating or referred pain in your shoulders, arms or hands.
Neck Conditions that Cause Referred and Radiating Pain
There are many ways the type of pain in your shoulders or arms could indicate that the cause may be in your spine. The source of the pain could be an injury such as neck strain, whiplash or vertebral fracture (broken neck) or it could be one or more conditions caused by repetitive stress or joint degeneration, such as:
Cervical Spondylosis — A progressive, degenerative joint condition caused by the reduction of cartilage and often associated with excess bone growth (spurs) and inflammation in the vertebrae. This may lead to irritation of or impingement on the nerve root.
Complex Regional Pain Syndrome — CRPS (aka: Reflex Sympathetic Dystrophy) is indicated by chronic pain that usually affects the limbs. CRPS pain may be experiences as “burning” pain, as well as swollen or stiff joints and changes in skin temperature or texture.
Degenerative Disc — Each of your spinal discs is separated and protected by a spongy, shock-absorbing “disc” that wraps around the spinal cord and keeps the vertebrae from scraping against each other. Over time, these discs may dehydrate or be worn down by use. The resulting pressure on the spinal cord and nerve roots causes neck pain, which may move into your shoulders, arms and hands. This pain could be either sharp or random or dull and persistent. If not properly treated, discs may continue to degenerate over time.
Facet Joint Inflammation — Facet Joints or “Z-Joints” are found on both sides of the back of the spine. These joints work together to both guide and limit the motion of the spine. However, when these joints become inflamed, that may cause muscle spasms, affecting your posture and the health of your spine. Typical symptoms of Facet Joint Inflammation include:
Intermittent, acute pain
Tenderness and loss of flexibility
Radiating pain in the shoulders and upper back
Foraminal (Cervical) Spinal Stenosis — When a joint in the spinal canal is enlarged, the corresponding cervical disc space narrows. Pain associated with this condition can be random, steadily worsening over years.
Herniated Disc — Sometimes, spinal discs may develop tears, and when these are large enough, the spongy, jelly-like material inside the disc, called the nucleus pulposus, can leak out. This often applies pressure to the nerve root, which can radiate pain into your shoulders and arms.
Pinched Nerves (Cervical Radiculopathy) — When a spinal nerve is constricted by surrounding tissue, this compression disrupts regular nerve function, causing pain, numbness and weakness, which starts in the neck and often radiates through the shoulders, into the arms and hands.
Radiculopathy causes a variety of pain and other symptoms from sharp, chronic pain to frequent, dull aches or mild but persistent tingling (“pins-and-needles”). This pain may be centralized in the shoulder or radiate down the arm.
The location of the symptoms can help the physician determine the location of the cause of the pain. This is because damage to the nerves in certain cervical vertebrae tend to cause pain or numbness in certain parts of the shoulder, arm or hand.
Pinched nerves in C5 often cause pain in the upper shoulder near the neck.
Pinched nerves in C6 may affect the outer shoulder and may radiate down into the thumb or side of the hand.
Pinched nerves in C7 cause pain in the inner shoulder, near the spine, as well as numbness or tingling in the wrist, middle of the hand and index finger.
Pinched nerves in C8 affect the lower shoulder, as well as the pinky side of the hand and wrist.
Spondylolisthesis — Small stress fractures may allow one vertebrae to slip onto another, causing pinched or inflamed nerves.
Diagnosing and Treating Your Spine-Related Arm or Shoulder Pain
Understanding your symptoms is a vital step in the diagnostic process, but it is only step one. To make a proper diagnosis, Dr. Skaliy will discuss your medical history and complete a physical examination to test your reflexes and responses, while looking for any pain, muscle weakness, numbness, or other issues that could be related to your expressed symptoms.
During the physical examination, be prepared to answer specific questions about your symptoms including:
Where it hurts
When it hurts
How long it hurts
Does anything make your symptoms better or worse
Are your currently taking any medication, whether related to the pain or not
Any recent injuries or accidents, even if you don’t think it’s related
This examination may be sufficient to make a diagnosis. However, if these protocols are in inconclusive, Dr. Skaliy cou