You can develop shoulder pain for many reasons: overuse, injury, or arthritis, to name a few. Another very common cause is cervical radiculopathy - a pinched nerve in your upper spine. In older adults, it's often due to spinal arthritis. In younger ones, it can be caused by an issue that leads to a herniated disc. But sometimes a pinched nerve just happens for no known reason. 

A pinched nerve that affects your shoulder region can be very painful and affect your quality of life, but most cases get better with light exercise and at-home treatment. 

Here, learn more about what causes pain in the shoulder from a pinched nerve, and how to prevent and treat it - especially with exercises from our Hinge Health physical therapists.

What Is a Pinched Nerve that Affects the Shoulder?

Sometimes, a pinched nerve in the cervical spine (neck) can cause symptoms that start at your neck and travel down your shoulder and even into your arm. It's often a sharp or burning pain that gets worse when you move your neck back or forth or side to side, says Steven Goostree, PT, DPT, a physical therapist at Hinge Health. 

Another clue: The pain may decrease when you put your hands on top of your head since this position relieves pressure on the nerve.

Symptoms of a Pinched Nerve

Other symptoms include:

• Tingling or pins-and-needles sensation in your shoulder, hand, and/or fingers

• Muscle weakness in your arm, shoulder, or hand

• A numb shoulder (your arm and hand may also be numb, too)

• Abnormal reflexes

• Tingling in the neck and/or shoulder

• Numbness in the upper back

Since cervical radiculopathy affects everyone differently, you may notice several of the above symptoms, or only one.

Understanding Your Anatomy

Your spine is made up of 24 vertebrae, bones that are stacked on top of one another to create a canal that protects your spinal cord. It consists of:

• Your cervical spine. These are the seven small vertebrae in your neck.

• Spinal cord. This contains nerves that carry messages between your brain and the rest of your body.

• Intervertebral disks. These flat, round, half-inch-thick disks act as shock absorbers to protect your spine when you move.

With cervical radiculopathy, a pinched nerve in the neck (cervical) region of the spine is sending pain into your shoulders and/or arms. 

Causes of Pinched Nerve in Shoulder Blade

There are three main reasons you develop a pinched nerve in your shoulder blade. Here's a closer look:

• Disc degeneration. This is the main cause of cervical radiculopathy. The discs in your spine age just like the rest of you. When they do that, they lose height. As a result, the vertebrae move closer together and this can create a situation where there is less room for the nerves.

• Herniated discs. If a disc is worn down with age or injured, its jelly-like center may be pushed out toward the spinal canal. This puts pressure on sensitive nerves, which can cause pain, numbness, and weakness in the arm. It's often the cause of a pinched nerve among younger people under the age of 50. It can happen due to posture issues,  improper lifting, bending, or twisting.

• Injury. "A pinched nerve can also happen if someone experiences an acute injury, like falling on an outstretched hand, or getting tackled in football," says Goostree.

When to See a Doctor 

If your symptoms don't go away after about a week, see your doctor. You should also see them right away if you experience any of the following: 

• Muscle weakness in your arm or hand. "If you experience any change in strength - for example, you can't grasp things, or drop things, it needs to be checked out," says Dr. Goostree.

• Abnormal reflexes in your arm 

• Any changes in your gait (how you walk) or balance, including feeling unsteady while walking

• Any loss of dexterity (such as difficulty with writing or fastening the buttons on your clothing)

• Pain that worsens at night

Your doctor will do a physical exam and possibly order other tests, like x-rays, MRIs, or CT scans.

Treatment for Pinched Nerve Affecting the Shoulder

"Your body has an amazing capacity to heal itself, so most people should feel better in six to eight weeks," reassures Dr. Goostree. Most of the time, symptoms resolve with nonsurgical treatments. Here's how to manage symptoms associated with a pinched nerve that is affecting your shoulder.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for a pinched nerve. It's important to make sure that you are safely able to take these medications, based on your medical history.

• Ice, then heat. Apply ice to your neck and shoulder blades for the first 48 hours after the pain starts. This will reduce inflammation. After that, use moist heat to help muscles relax. 

• Oral corticosteroids.  If used for a short period of time, they can reduce swelling and inflammation.

• Steroid injections. If over-the-counter medication does not offer sufficient pain relief, your doctor may suggest cortisone (steroid) injections to help counter pain and inflammation. These are injected near the affected nerve to reduce inflammation.

• Physical therapy. Your doctor may recommend that you undergo physical therapy, which can include range-of-motion, strengthening, and aerobic exercises. A 2019 review of 10 studies published in the journal Medicine found that these types of activities help improve pain, quality of life, and overall physical function.

• Cervical collar. This is a padded ring that you wrap around your neck. It allows your neck muscles to rest, and limits neck motion to decrease nerve pinching. It's not recommended for more than a week or two - longer than that can decrease neck muscle strength.

Surgery for a Pinched Nerve

You should feel better within six to eight weeks. But if you don't, or your symptoms worsen and significantly impact your quality of life,  your doctor may recommend surgery. "It should really be a last-ditch effort for people who have constant numbness or tingling that interferes with activities of daily living," says Dr. Goostree. There are three main types:

• Anterior cervical discectomy and fusion (ACDF). This is the most common procedure. It removes the problematic disc to make more room for the pinched nerves, then stabilizes the spine through spinal fusion.

• Artificial disc replacement (ADR). This removes the broken-down disc (to make more room for the pinched nerves) and replaces it with an artificial one (similar to a hip or knee replacement) in order to keep the spine more flexible and maintain a normal range of motion.

• Posterior cervical laminoforaminotomy. Your doctor will thin down your lamina - the bony arch that makes the back of your spinal canal - then remove any bone, bone spurs, and tissues that are compressing your nerve root and causing pain.

Talk to your doctor about whether you're a good candidate for surgery. 

Exercises for Pinched Nerve Affecting the Shoulder 

Here are a few gentle exercises from Hinge Health that are commonly used to help with pain from a pinched nerve that is impacting your shoulder:

PT Tip: Sit Sporadically

Sitting in the same position for prolonged periods of time can take a toll on your neck — and, in turn, your shoulder. If you work at a desk, take five-minute breaks throughout the day, Dr. Goosetree recommends. When you do sit, use car or chair arm rests to keep your arms supported. Your position at night counts too: Try to sleep with your neck in a neutral position by placing a small pillow under your neck if you sleep on your back, or sleep with enough pillows to keep your neck in a straight line with your body if you’re a side sleeper.

Learn More About Hinge Health for Shoulder Pain

Our digital programs for back and joint pain are offered for free through benefit providers. Click here to see if you’re eligible.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

Sources

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6. Borrella-Andrés, S., Marqués-García, I., Lucha-López, M. O., Fanlo-Mazas, P., Hernández-Secorún, M., Pérez-Bellmunt, A., Tricás-Moreno, J. M., & Hidalgo-García, C. (2021). Manual Therapy as a Management of Cervical Radiculopathy: A Systematic Review. Biomedicine Research International. doi:org/10.1155/2021/9936981

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