Understanding
Neck and Shoulder Pinched Nerve Pain

Your neuromuscular system represents the critical connection between your brain and your muscles, governing and coordinating movement and sending messages to and from the brain about your body’s position in space, muscle contractions and sensory information. When nerves become impinged, or pinched, neural messaging is impeded, and you experience pain at the nerve root, along with motor deficiencies and reduced performance in the muscles associated with the nerve.

Nerves that exit from the intervertebral spaces in your neck govern your upper back, chest, shoulder and arm muscles, and those nerves can restrict movement and cause pain throughout your upper body. When nerves that innervate your rotator cuff muscles are impinged, you may feel pain and weakness in your shoulders and shoulder blades that inhibits overhead arm movement.

Causes of Nerve Impingement

Nerve impingement is pressure on a nerve root imposed by another body structure. Inflammation of soft tissues surrounding the nerve, or pressure from a bone, cyst or connective tissue can cause impingement. Pressure can also originate within the vertebral space from a bulging or herniated disc that puts pressure on an adjacent nerve.

Nerve entrapment is related to but distinct from nerve impingement. It occurs when a nerve adheres to bone by fibrous tissue, when a bone is fractured, or when a cyst or large vein entraps the nerve, keeping it from gliding within the body as it moves.

When nerves are impinged or entrapped, blood flow to the nerve is restricted, interfering with its ability to transmit action potentials to the muscles. Over time, restricted blood flow can cause permanent damage to the nerve, limiting muscle activity and creating a cascade of movement and postural deficiencies that can become debilitating.

In older adults, normal wear and tear over time combined with postural deficiencies and joint conditions like arthritis can cause pinched nerves. In younger people, overuse from physical activity or injury are the most common causes of nerve impingement.

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Nerve Impingements Affecting the Neck and Shoulder

The location and nature of nerve impingement dictates which muscles are affected, and what treatment strategies are appropriate.

Suprascapular neuropathyoccurs when the nerve that runs along the back of the shoulder beneath the trapezius muscle is overstretched or compressed. The condition, while rare, is most often seen in athletes whose sports require overhead movements, like swimmers, tennis players, shot putters and baseball pitchers. Compression or entrapment of the suprascapular nerve may present as mild shoulder pain, with symptoms most prominent on the athlete’s dominant side. The athlete may experience weakness, impaired mobility and reduced performance.
Cervical spine impingementoccurs in the nerves where they exit the spinal column at the neck and branch out to innervate the upper body muscles. Compressed or irritated nerves can cause pain, tingling and numbness to radiate along the nerve’s pathway, affecting associated muscles. The cause is often trauma from an automobile accident or sports collision, where inflammation and soft tissue damage exerts pressure on the nerves.
Cervical herniated discsarise when they are compressed to the point where the inner disc material bulges and leaks out, causing inflammation, and pressing on adjacent nerves.
Cervical spinal stenosisis most often seen in adults over age 60, and is due to degeneration of the space within the spinal canal, which can cause nerves to become compressed.
Cervical degenerative disc diseaseis most common in adults over age 50, where the spinal discs stiffen and become flatter, reducing support to the spine, and causing inflammation that impinges nearby nerves.
Text neckis a 21st Century affliction resulting from frequent long bouts of electronic devise use. The weight of the head shifts forward, causing severe strain of the upper back muscles, which can lead to nerve compression.

Diagnosis for Pinched Nerves in the Neck and Shoulder

Symptoms of neck and shoulder pain may also stem from other sources, making accurate diagnosis a critical factor for treatment. A patient history and physical exam will precede and be confirmed by real time diagnostic ultrasound, which gives a close up view of the structures of the neck.

Please explore more advanced diagnostic option unavailable anywhere else:

Sonoelastography SMI

Diagnosis for pinched nerves in the neck and shoulder

Treatment for Neck and Shoulder Pinched Nerve Pain

Traditional treatment for pinched nerve pain targets the locus of pain with the aim of reducing inflammation and decreasing pressure on the nerve. Treatment may include:

Ice and NSAIDs to treat pain and inflammation
Rest and activity modification
Corticosteroid shots
Chiropractic manipulation
Physical therapy

Pinched Nerve Therapy at NYDNR

The sports medicine professionals at NYDNRehab use state-of-the art technologies and innovative treatment methods to identify and correct compressed and entrapped nerves.

Some of our treatment methods include:

Real time dynamic ultrasound
DNS (dynamic neuromuscular stabilization)
Exercises for upper body motor control
Range of motion exercises
Acupuncture
Postural correction
Gait analysis and retraining
ESWT (extracorporeal shock wave therapy)

Many of our technologies and treatment approaches are unique to our midtown Manhattan Physical Therapy clinic, and cannot be found at other clinics. Our end goal is to go beyond treating pain, to getting to its source, eliminating it, and restoring optimal function to the patient.

Research at NYDNRehab

Conference: EFIC Congress 2019 – Pain in Europe XIAt: Valencia, Spain https://www.researchgate.net/publication/336216932_DRY_NEEDLING_UNDER_ULTRASOUND_GUIDANCE_TRIGGER_POINTS_IN_NECK_AND_SHOULDER_EFFECTIVE_OR_DIFFERENT_TYPES_OF_HEADACHE

PRECISE DRY NEEDLING OF TRIGGER POINTS IN NECK, SHOULDER AND PTERYGOID MUSCLES IS EFFECTIVE TO TREAT MIGRAINE AND HEADACHE AND RESTORE POSTURE October 2020 Cephalalgia 40(S1):109-110 https://www.researchgate.net/publication/344808393_PRECISE_DRY_NEEDLING_OF_TRIGGER_POINTS_IN_NECK_SHOULDER_AND_PTERYGOID_MUSCLES_IS_EFFECTIVE_TO_TREAT_MIGRAINE_AND_HEADACHE_AND_RESTORE_POSTURE

Understanding Neck and Shoulder Pinched Nerve Pain

Our Awards

Diagnosis for Pinched Nerves in the Neck and Shoulder

Research at NYDNRehab

Understanding
Neck and Shoulder Pinched Nerve Pain