What happens with a pinched nerve in the shoulder?
Doctors may also refer to a pinched nerve in the shoulder arising from the neck as cervical radiculopathy.
An acute injury or changes to the body over time can cause a pinched nerve in the shoulder. This article will identify common symptoms, causes, and treatments for the condition.
Signs and symptoms
Disk degeneration or herniation can cause a pinched nerve in the shoulder.
A pinched nerve in the shoulder will typically cause pain, numbness, or discomfort in the shoulder region.
A person may also have other symptoms, which include:
- changes in feeling on the same side as the shoulder that hurts
- muscle weakness in the arm, hand, or shoulder
- neck pain, especially when turning the head from side to side
- numbness and tingling in the fingers or hand
A pinched nerve in the shoulder occurs when material, such as bone, disk protrusions, or swollen tissue, puts pressure on the nerves extending from the spinal column toward the neck and shoulder.
The spinal column consists of 24 bones called vertebrae that sit atop each other with protective, cushion-like disks between each one.
Doctors divide the spinal column into three regions based on the area of the body and the appearance of the spinal bones. These include:
- Cervical spine: Consisting of the first seven vertebrae.
- Thoracic spine: Made up of the middle 12 vertebrae.
- Lumbar spine: Consisting of the last five vertebrae.
A pinched nerve in the shoulder affects the cervical spine specifically. Extending from the cervical spine are nerves that transmit signals to and from the brain to other areas of the body.
Some common causes of a pinched nerve in the shoulder include:
- Disk degeneration: Over time, the gel-like disks between the cervical vertebrae can start to wear down. As a result, the bones can get closer together and potentially rub against each other and the nerves. Sometimes, a person will develop bony growths on their vertebrae called bone spurs. These can also press on shoulder nerves.
- Herniated disk: Sometimes a disk can stick out and press on nerves where they exit the spinal column. A person will tend to notice this pain more with activities, such as twisting, bending, or lifting.
- Acute injury: A person can experience an injury, such as from a car accident or sports activity, that causes a herniated disk or tissue inflammation in the body that presses on the nerves.
A doctor can usually identify the cause of a pinched nerve in the shoulder by taking a medical history, doing a physical exam, and requesting imaging studies.
How does a doctor diagnose shoulder pain?
A doctor can use an X-ray to diagnose a pinched nerve.
Doctors will start to diagnose a person's shoulder pain by taking a history and doing a physical examination.
They will ask a person about the symptoms they are experiencing, such as when they first noticed these, and what makes them worse or better. A doctor will also examine the shoulder, neck, and surrounding areas to try to identify any noticeable problems.
A doctor will often order further tests to confirm a diagnosis or rule out other causes. Examples of these tests include:
- X-ray or computed tomography (CT) scan: These tests provide details of spinal bones to help identify changes to the bones that may be pressing on a nerve.
- Magnetic resonance imaging (MRI): This test provides greater detail of soft tissue and nerves that a CT scan or X-ray cannot.
- Electrodiagnostic studies: These tests use special needles that send electrical signals to different areas of the neck and shoulder. They can test the nerve functions in the body to work out where one is compressed.
These tests can help a doctor identify a pinched nerve in the shoulder or another condition that may also cause shoulder pain. Examples of other conditions include:
- a tendon tear
- arthritis or inflammation of the joints
- bursitis or inflammation of the fluid-filled sacs that cushion the joints
- shoulder fracture
Most people with a pinched nerve in the shoulder will get better over time and do not require any treatment.
When necessary to make treatment recommendations, a doctor will consider:
- what is causing the pinched nerve
- how severe the pain is
- how the pinched nerve affects daily activities
A doctor will usually recommend nonsurgical treatments first. If a person's pain does not respond to these treatments or gets worse, the doctor may then recommend surgery.
Nonsurgical treatments for a pinched nerve include:
- taking nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen
- taking oral corticosteroids to relieve inflammation
- injecting corticosteroids to reduce swelling and inflammation
- wearing a soft, cervical collar to limit movement in the neck to allow the nerves to heal
- undertaking physical therapy and exercises to reduce stiffness and improve range of motion
- taking pain-relieving medication for a short time to reduce the most immediate effects of shoulder pain
Sometimes pain due to a pinched nerve in the shoulder will come and go. But if a person's pain is the result of degenerative changes, their pain may worsen with time.
If the above treatments no longer relieve pain, a doctor may recommend surgery. Types of surgery can include:
- Anterior cervical discectomy and fusion (ACDF): In this procedure, a surgeon accesses the neck bones from the front of the neck. They will remove the area of disk or bone that is causing pain before fusing areas of the spine together to reduce pain.
- Artificial disk replacement: This procedure involves replacing a diseased or damaged disk with an artificial one made from metal, plastic, or a combination of both. As with an ACDF, a surgeon will access the spinal column from the front of the neck.
- Posterior cervical laminoforaminotomy: This procedure involves making a 1- to 2-inch cut on the back of the neck and removing portions of the spine that may be pressing on the nerves in the back.
- Decompression of the suprascapular nerve: This means the surgeon tries to free up the nerve in the region of the scapular notch if this nerve is compressed.
The surgical approach will depend on a person's symptoms and what area of the spine or tissue is pressing on the nerves.
Managing a pinched nerve in the shoulder
An ice pack can help to manage intense symptoms of a pinched nerve.
The pain from a pinched nerve in the shoulder often comes and goes. When a person is experiencing intense symptoms, they may wish to try the following:
- Apply cloth-covered ice packs to the neck and shoulder blade area over a period of up to 48 hours after the pain began. After this time, they can use warm, moist heat to relieve pain.
- Sleep with a pillow designed to support the neck. These pillows are available to purchase online.
- Take anti-inflammatory or pain-relieving medications.
When a person's symptoms start to get better, they may want to try doing the following to help prevent further episodes of pain:
- Focusing on proper postures when sleeping and sitting at a desk. People can use devices, such as a hands-free phone, to avoid having to strain or move the neck repetitively. Adjusting chair and keyboard height may also reduce strain on the back.
- Engaging in regular exercise to reduce stiffness and help maintain a healthy weight.
- Having massages that can boost circulation to inflamed areas, which can aid healing. Massages can also relieve muscle tension.
A physical or occupational therapist can be helpful in recommending exercises and giving advice on how to improve posture at home and at work.
A pinched nerve in the shoulder can be a painful problem that can lead to weakness, tingling, and numbness in the hand and arm.
Over-the-counter measures can usually help to reduce symptoms. If these methods do not work, surgical options are available.
People should always talk to their doctor when they have shoulder pain that lasts beyond a few days.
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