When our shoulder hurts, we naturally assume we have a problem in, well, the shoulder. But in reality, shoulder pain often indicates a spine problem, according to Kaliq Chang, MD, of Atlantic Spine Center.
Shoulder pain and injuries certainly aren’t rare, accounting for nearly 20% of visits to doctor’s offices, according to the Cleveland Clinic. But our bodies don’t always report pain in dependable ways, explains Dr. Chang, an interventional pain management specialist.
With 8 nerve roots stemming from each side of the cervical spine in the neck, 5 of these roots pass through part of the shoulder on each side. If any of these nerve roots become pinched or irritated, pain and other resulting symptoms can land in the shoulder area. This is known as “referred pain,” which is felt somewhere other than where it originates, Dr. Chang says.
“Sometimes, pain in our shoulder is really due to an undiagnosed or unrecognized condition in the cervical spine,” Dr. Chang says. “That’s because the neck and shoulder are highly connected by many nerve pathways. While it can seem puzzling, it actually makes perfect sense that shoulder pain can be caused by spine problems.”
Symptoms of shoulder pain from the spine
According to Dr. Chang, when a nerve root in the neck gets pinched (a scenario known medically as cervical radiculopathy) right and left shoulder blade pain and other symptoms can feel:
- Sharp and severe
- Dull or mild
- In one place, such as the shoulder blade, or radiating from shoulder to arm
- Tingling and numbness
- Occasional or constant weakness
- Pain, numbness or tingling past the elbow
Shoulder pain causes
Of course, nerves in the cervical spine don’t get pinched all by themselves. Several spine problems in the neck area can trigger these shoulder symptoms, Dr. Chang says. Shoulder pain causes include:
- Degenerative disc disease, disc hydration lose usually due to aging
- Herniated disc, which happens when the disc’s outer layer tears and lets inner gel leak out
- Osteoarthritis, the “wear and tear” or thinning that can happen at almost any joint location
- Foraminal stenosis, which occurs when a nerve root becomes compressed while passing through a small hole called a foramen in the bony vertebrae
“Other, less-likely conditions such as a spinal tumor can also potentially cause pinched nerves in the neck that trigger left or right arm pain from shoulder to hand,” Dr. Chang says. “But the vast majority of the time, shoulder pain originating in the neck has a straightforward cause that isn’t dangerous and can be readily addressed.”
Tests and diagnosis
In many cases, home remedies can help you ease the pain, but if the pain doesn’t go away for a while, you should seek medical care.
The diagnosis is usually performed in several phases. The first is medical history. For a physician to diagnose a condition causing pain in the left shoulder and arm, they need to look at a few different aspects of your pain. The medical history of the patient is taken into account, along with a physical examination. To determine your diagnosis, a doctor will ask you to describe the symptoms and pain. Usually, he or she can ask when the pain started, whether it gets worse after certain activities or times of the day, and whether it affects your daily life.
During the physical examination, the physician will test for nerve function, as well as how strong the muscle is in certain areas of the neck, shoulders, and arms. The physical manipulation tests that are performed should give your doctor a good idea of your condition.
An accurate diagnosis often involves using a variety of imaging tests and tools:
- X-rays, which show the structure of spinal vertebrae and the outline of spinal joints;
- MRI, CT, and PET scans, which produce images of the bones;
- A blood test can be performed if the pain seems to be caused by an infection.
- A nerve conduction test, known as electromyography, or EMG, can also tell your doctor if your symptoms are caused by pressure on spinal nerve roots.
Shoulder pain treatment options
Like most pain originating in the spine, shoulder pain from spine problems tends to ease on its own within several weeks, Dr. Chang says. But if pain persists, or your range of motion is seriously affected, it’s best to see a doctor.
A short period of rest helps your shoulders heal. To reduce the pain, you can use some home remedies like ice packs or heat and apply them to the aching spots.
In general, treatment depends on the severity of the symptoms. Usually, the first option is conservative treatment like medications.
In more serious cases, your doctor can recommend some procedures or therapy. Physical and occupational therapy can be very effective for pain in right shoulder treatment. A therapist can show you special exercises to strengthen muscles and increase flexibility. You can also improve aerobic conditioning with gentle exercises like walking and water therapy. An occupational specialist can also help you find movements that cause less pain.
Also, there are some alternative therapies, such as acupuncture, massage, or yoga. Some forms of massage therapy can be helpful to relax tight muscles and improve circulation. It can relieve pain, as well as prevent future damage.
Even though rest can help you heal, do not avoid movement at all times. It is essential to keep your muscles active and joints active to prevent stiffness and improve circulation. Some physical exercises can also improve balance, strength and mobility.
Preventing shoulder, neck, and back issues is the best thing you can do to minimize the chance of developing some conditions and pain.
Regular exercise - cardiovascular exercise and stretching - strengthen the supporting muscles and improve flexibility.
Good nutrition can also help your joints and muscles. Foods that are high in calcium and vitamin D, such as dairy foods and leafy green vegetables, can help prevent the bones from becoming thin and brittle. Drinking enough water is another key part of nutrition. As liquid is an essential part of back tissues and many issues originate from tissue dehydration, mind your water intake.
Get back to peak performance with our world-class team of physical therapists, rehabilitation experts, chiropractors and board-certified physicians. We take hip and groin pain very seriously and will help you get back to your best condition quickly and naturally, without drugs or surgery if at all possible.
Avoid slouching and practice good posture. To do this, place your computer screen at eye level, with a document holder that positions your work at screen level.
Try to invest in proper equipment. Using a high-quality chair, a good mattress and a pillow allows you to maintain good posture while sitting and get a good sleep to prevent back issues.
Use proper lifting techniques. Do not bend at the waist. Bend your knees while keeping your back straight, and use your strong leg muscles to help you support the load.
Medications for shoulder pain
Medications such as NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen and ibuprofen or prescription oral corticosteroids can cut swelling and inflammation around spinal nerves.
“Occasionally, permanent nerve damage can occur if the problem isn’t monitored or treated,” Dr. Chang says.
In the meantime, a variety of non-surgical treatments may help ease shoulder joint pain. These include:
- Soft cervical collar, which can help reduce nerve root pinching
- Physical therapy, which can teach exercises to strengthen neck muscles, reduce pain and improve range of motion
- Steroid injections near the affected nerve
Surgery for shoulder pain
For additional information on pinched nerves and a short video, visit our dedicated webpage on Pinched Nerves.