Often times when people experience pain in a certain body part they attribute that body part as the problem. This is a natural assumption and in most cases is correct. However, when it comes to arm and shoulder pain, the problem is not always what it seems.
Most arm and shoulder pain results from an injury or condition in the arm/shoulder itself. However, shoulder pain can also stem from a problem in the neck. When shoulder pain is actually coming from the neck, it is wise to seek treatment as one or more nerves running from the neck into the shoulder could be at risk.
Is the Pain in My Arm Caused by My Neck?
There are eight nerve roots branching from each side of the cervical spine in the neck, and they’re labeled C1-C8. Nerve roots C3 through C8 all pass through a specific part of the shoulder. If a cervical nerve root becomes compressed or irritated in the neck, it can cause pain and symptoms that radiate along the path of the nerve into the shoulder, arm and/or hand. This is medically termed cervical radiculopathy.
Symptoms of Cervical Radiculopathy
Radicular pain and accompanying symptoms can vary and include any or all of the following:
- Pain that feels anywhere from mild to sharp, or severe.
- Pain that comes and goes, or is constant and unrelenting.
- Pain that stays in the same area, such as the shoulder blade, or pain that radiates along the nerve and could go from the shoulder down the arm.
- Tingling that might feel like a pins-and-needles sensation, which could be in one spot or radiate through the shoulder and into the arm.
- Weakness or numbness in the shoulder and/or arm, which could be constant or sporadic.
Some research indicates that shoulder pain symptoms tend to develop with the following pattern:
- C5 radiculopathy tends to lead to pain in the upper shoulder near the neck and could either be sharp pain on the surface or a deep, achy pain.
- C6 radiculopathy would be more on the outer shoulder and likely a pain that feels closer to skin level.
- C7 radiculopathy would be the inner part of the shoulder closer to the spine and would likely have pain that feels surface-level rather than deep.
- C8 radiculopathy, which is less common than the others, would be the lower shoulder and could have pain that is either sharp on the surface or deep and achy.
Symptoms may vary from the above depending on the underlying pathology, as well as an individual’s unique anatomy and perception of pain. Most commonly, cervical radiculopathy is experienced on only one side of the body.
What Causes Cervical Radiculopathy?
Cervical radiculopathy is often caused by “wear and tear” changes that occur in the spine as we age, such as arthritis. In younger people, it is most often caused by a sudden injury that results in a herniated disk.
As the disks in the spine age, they lose height and begin to bulge. They also lose water content, begin to dry out, and become stiffer. This problem causes settling, or collapse, of the disk spaces and loss of disk space height.
As the disks lose height, the vertebrae move closer together. The body responds to the collapsed disk by forming more bone (bone spurs) around the disk to strengthen it. These bone spurs contribute to the stiffening of the spine. They may also narrow the foramen (the small openings on each side of the spinal column where the nerve roots exit) and pinch the nerve root.
Degenerative changes in the disks are often called arthritis or spondylosis. These changes are normal and they occur in everyone. In fact, nearly half of all people middle-aged and older have worn disks and pinched nerves that do not cause painful symptoms. It is not known why some patients develop symptoms and others do not.
Other causes of cervical radiculopathy include:
- Cervical Osteoarthritis. When a facet joint in the neck becomes arthritic, the inflammation and excess bone growth can alter the joint’s size and spacing, which could result in a nerve root being irritated or impinged.
- Cervical Foraminal Stenosis. This condition occurs when the nerve root becomes compressed while going through the foramen. The narrowing of the foramen can happen in various ways, such as the overgrowth of bone spurs or by a herniated disc.
Treatments for cervical radiculopathy typically include one or more of the following:
- Rest or activity modification: Limiting strenuous activities, like sports or lifting heavy objects, or using better posture while sitting or driving might provide some relief.
- Physical therapy: A physical therapist or other certified health professional might prescribe an exercise and stretching routine that is specific for the patient’s needs. Improving the neck and back’s strength and flexibility may help them to hold better posture and become more resistant to pain.
- Ice and/or heat therapy: Applying an ice pack or a heated gel pack to the neck might offer pain relief for some people. For example, applying cold therapy after an activity-related flare-up of pain may help reduce inflammation and therefore pain. When applying ice or heat therapy, it is important to have a layer that prevents direct contact with the skin, and limit applications to 15 or 20 minutes at a time with about a 2-hour break in between.
- Medications. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first medications tried to relieve inflammation related to cervical radiculopathy. Examples could include aspirin, ibuprofen, or naproxen. If symptoms are not reduced or well managed, stronger medications may be prescribed on a short-term basis, such as prescription-strength NSAIDs, muscle relaxants, or opioid-based medications.
- Manual manipulation: A chiropractor or other qualified health professional can manually adjust the cervical spine with the goal of improving mobility and providing a better healing environment. Sometimes manual manipulation is part of a physical therapy program.
- Cervical traction. A cervical traction device gently applies weight in a manner to slightly pull up on the head. This process aims to increase the space between cervical vertebrae, especially in the intervertebral foramina where the nerve roots pass. If a patient experiences symptom relief when trying traction in a clinical setting, a home traction device may be recommended.
If standard treatments are not providing pain relief from cervical radiculopathy, or if neurological symptoms of arm numbness and pain continue to progress, alternative treatments must be considered.
Stem cell therapy is one of the most effective and nonsurgical solutions for cervical radiculopathy. The stem cell therapy can reduce inflammation and decrease nerve compression. The therapy can reduce pain as well as the possibility of surgical interventions.
According to orthopedics, advancement in stem cell treatment has made it possible for doctors to treat diseases like cervical radiculopathy. After collecting and concentrating the stem cells, specialists apply them directly to the damaged area.
Experts collect different types of stem cells from different sources including blood, bone marrow, and fat tissues and they are concentrated with various growth factors like human growth hormones. These substances stimulate the stem cells and help them to repair the damaged spinal disks.
A throbbing pain in the arm may indicate something more than just an injured arm. It can be the symptom of a more intricate problem involving the nerves and disks in the neck. Luckily, there are plenty of treatments for this condition. How the body reacts to these treatments will determine which option is best.