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Shouldering the pain
Shoulder pain can develop from a variety of sources, such as tendinitis, arthritis, torn cartilage, and many other medical conditions and injuries. One other common cause of shoulder pain is a pinched nerve in the upper spine, also known as cervical radiculopathy.
A nerve can become pinched when bone spurs form around the spinal discs. These discs are the “shock absorbers” between the vertebrae in your spine. Bone spurs are new formations of bone that grow when discs start to weaken with age.
As you get older, the vertebrae become compressed and the discs become thinner. Bone spurs grow around the discs to strengthen them, but that new bone growth can put pressure on the nerve root in the spine.
If a pinched nerve is causing your shoulder pain, you’ll need a thorough physical exam of your neck and shoulder to diagnose the problem.
However, there are signs that may help steer you and your doctor in the right direction.
A pinched nerve usually causes pain in one shoulder only. It’s also typically a sharp pain, as opposed to a dull ache or a strain that you might feel if you overworked your muscles.
Pain may also worsen if you turn your head. Neck pain and headaches in the back of your head are also signs that the cause of all this discomfort is a pinched nerve.
A pinched nerve may also leave you with a feeling of “pins and needles” in your shoulder. The joint may also feel numb or weak when you try to lift something.
In some cases, symptoms extend from the shoulder down the arm to the hand.
A spine specialist may be able to tell which nerve is being pinched based on the location of your symptoms. However, a comprehensive exam is also necessary. That includes a physical exam of the neck and shoulders.
Your doctor will probably test your reflexes, sensation, and strength. You may be asked to do certain stretches or movements to demonstrate what causes your symptoms, as well as what relieves them.
It’s also important that you provide details about your shoulder pain.
You should inform your doctor of when the pain first started and what causes your shoulder to hurt. Also explain or show what causes the pain to subside. Your doctor may want to know if you’ve started exercising more or increased other physical activities.
If you’ve injured your neck or shoulder, you’ll need to provide details of the injury. Because nerves in the spine affect many aspects of your health, you should also tell your doctor if you’ve noticed a change in your bowel habits or bladder function.
An X-ray can provide details of the bones in the spine, but not the nerves and discs. However, an X-ray can tell a doctor how much narrowing has occurred between the vertebrae and whether bone spurs have developed.
An MRI is often more helpful at diagnosing a pinched nerve. That’s because an MRI can reveal the health of nerves and discs. An MRI is painless and doesn’t use radiation.
For pain concentrated in the shoulder, an X-ray of the joint may be performed to look for signs of arthritis or injuries to the bones.
An MRI or ultrasound (another noninvasive imaging test) can show the soft tissue in the shoulder and can determine whether the pain is being caused by injured ligaments or tendons.
If the source of your shoulder pain is a pinched nerve, your doctor may recommend physical therapy to improve strength and flexibility in your neck and shoulder.
You may also be advised to limit the movement of your neck. That may be done with traction or a soft collar worn around the neck for short periods of time.
Other treatments may include anti-inflammatory pain relievers or injections of steroids in the area of the affected nerve. Steroid injections can reduce pain and swelling.
If the problem is severe enough, surgery may be an option to remove the bone spur pinching the nerve.
Because a pinched nerve is a problem that can be diagnosed and treated, you shouldn’t hesitate to have that pain in your shoulder evaluated. If the pain is being caused by a different condition, you’re better off knowing what it is so you can avoid further damage and discomfort.