Shoulder pain is one of the frequently encountered musculoskeletal problems in adults belonging to all age groups and according to a 1993 study published in peer reviewed "Scandinavian Journal of Primary Care", the author suggested that almost 15% of all the males and 25% of the adult females experience frequent episodes of neck pain (at least one episode per month). There are many potential causes for shoulder pain. A pinched nerve can be one of the causes. Understanding how pinched nerve happens as well the corresponding treatments can help you relieve shoulder better.

What Should We Know about Pinched Nerve in Shoulder

Causes

Pinched nerve is the most common cause of neck pain in shoulder that originates in individuals who are exposed to strenuous physical activity (especially in poorly trained athletes) that causes inflammation or over-stretching of peripheral nerve fibers at certain places (when nerve is exiting through the tiny foramina in the cervical vertebrae) or when the nerve is entering or leaving the joints. Other common causes of pinched nerve include:

• Poor posture or poorly regulated physical activities
• Obese individuals
• Long standing and poorly regulated herniated spinal discs and widespread osteoporosis.

Symptoms

If left untreated, pinched nerves can interfere with normal daily activities to a great deal. Since all the muscular and functional activities of upper limb is controlled by nerves, in poorly managed cases symptoms like frozen shoulder, poorly coordinated muscular activities, tingling sensation in the limbs, pin and needle sensation in arms and poorly regulated muscle activities are reported.

Diagnosis and Tests

In most cases, relevant medical history and physical examination is needed by the healthcare provider to establish a preliminary diagnosis of pinched nerve in the shoulder. Healthcare providers also seek relevant medical, surgical and physical history and conduct motor assessment tests to ascertain the degree of nerve involvement. The preliminary diagnosis is confirmed by specialized tests like CT scan and MRI of spine to know the exact cause and site of lesion in order to plan appropriate treatment plan.

Treatments for Pinched Nerve in Shoulder

Spending upon the primary cause and severity of symptoms, a lot of treatments can be planned, most commonly employed ones are listed below:

1. Ice and Rest

In order to manage acute pain, ice therapy is employed by most individuals to decrease the inflammation and swelling across the nerve. Moreover, it also numbs and temporarily anesthetizes the site of primary nerve involvement until other interventions exert their action. , It is recommended to wrap your ice pack or a bag of peas in a towel before putting it on your neck.

Meanwhile it is also recommended to give optimal rest to the involved limb in order to decrease the spread of inflammation.

2. Exercise

Certain exercises are extremely helpful in decreasing the degree of inflammation by correcting the posture and stabilizing the connective tissue matrix. It is extremely important to avoid strenuous exercise and activity that involves upper limb without assistance and help of your primary healthcare provider. For best results, it is always better to seek professional help in the form of registered physical therapist who helps in restoration of normal posture by suggesting appropriate exercises.

3. Shoulder Shrugs

Shoulder shrugs are very helpful in improving the normal motility and flexibility of movements across the shoulder joint. For best results, perform the activity in standing posture. Ideally, shrug your shoulders by elevating your elbows at the level of shoulder and rotate then both shoulders simultaneously in the clockwise direction. Repeat this exercise at least 15 to 30 times every day.

4. Chin Extension

Chin extension is a simple exercise that you can perform in the sitting position. It involves supporting the back of your head by interlacing your fingers and rotating your neck to the right side by touching your chin with the right shoulder tip. Hold the position for 10 seconds and repeat the exercise fore left side.

5. Bench Press

You can use a broom to support your elbows while you are lying on a flat surface (ground or bench). Now elevate your elbows and press upon broom for 20 to 30 seconds. Do not use barbell for this activity.

6. Physical Therapy

Physical therapy helps by increasing the range of motion at the level of shoulder point. Moreover, by facilitating pain free smooth movement, physical therapy helps tremendously in increasing the flow of blood across the shoulder joint to ensure speedy recovery of the damaged nerve. Physical therapists may provide a wide range of treatment modalities such as traction or home-exercise program.

7. Medication and Management Options

• NSAIDs or nonsteroidal anti-inflammatory drugs (NSAIDs) include over the counter pain killers like aspirin or ibuprofen that are helpful in reducing pain and swelling as a result of inflammation.
• Oral corticosteroid helpful in reducing swelling and pain as a result of an ongoing inflammatory process.
• Narcotics are powerful analgesics that are needed to decrease pain and discomfort that is refractory to over the counter pain killers, It is recommended to follow the prescription of healthcare provider religiously in order to prevent the risk of addiction, dependence and tolerance
• Steroid injections are extremely helpful in decreasing swelling and inflammation and allowing inflamed nerves to heal optimally.
• Splint or collar helps in limitation of neck movement that gives muscles, tissues, tendons and ligaments ample time to recover from the inflammatory process.

8. Injection

In cases of severe pain, discomfort and limitation of movement as a result of severe inflammation of pinched nerve, injection at the level of nerve can help in reduction of pain and inflammation. It is indicated in cases where pain does not respond to any other methods of intervention.

9. Surgery

Surgery is needed in the cases that are refractory to holistic or alternative methods of care. Pinched nerve, caused by herniated cervical disc responds fairly well to the surgical management.

Surgery is also recommended if the patient has additional weakness in the muscles, or if the pinched nerve in shoulder causes loss of control over the bowel or bladder (cauda equina syndrome), which are signs of more serious nerve damages.