What Can Cause Arm and Shoulder Pain?

Pain and other symptoms in the arm and shoulder may be due to injury of the neck or cervical spine. The seven cervical vertebrae (spinal bones) in the neck have highly mobile joints so that you can bend and tilt your neck. Since the neck is exceptionally flexible, it is susceptible to injury and pain which can be referred to the shoulder and the arm. (It should be noted, however, that pain in the arm and shoulder may be due to other conditions not related to the cervical spine such as frozen shoulder, strain/sprain syndromes, osteomas, etc.)

The vertebrae are separated by discs, which are stiff jelly-like pads that act as elastic cushions between the spinal bones. Neck, shoulder and arm pain may be caused by an abnormal bulging or protrusion of a disc in the cervical spine, The disc may impinge on the spinal nerve roots or irritate the spinal cord itself. This is also known as a herniated or slipped disc.

Cervical disc lesions that can cause arm and shoulder pain can be acute or chronic. For example, sudden and severe pain (acute torticollis) can result from lying too still for too long, on a pillow too thick or too thin, or in a position that keeps the neck in a sideways position for a long period.

Another way of developing acute torticollis is a whiplash injury or by simply stretching (see figure below). Severe neck stiffness can result, sometimes with discomfort in both arms, and pins and needles in the fingers.

Pain in the shoulder blade (the scapula) may also be due to cervical disc trouble. It is also a common site for referred pain secondary to gall stones or a transverse humeral ligament tear or rupture. This scapular pain may radiate from the shoulder blade up to the base of the skull. Pressure on the nerve that innervates the arm area (the brachial nerve) from cervical disc injury can also cause pain in the shoulder, arm and chest.

Still other causes of shoulder and arm pain may include referred pain, such as from a heart attack, as well as regional disorders of the shoulder, elbow, wrist and hand. These conditions may include osteoporosis, tumors or cancerous growths, bursitis, neuritis and damage to the nerves and spinal cord.

What Can I Do to Ease the Pain Temporarily?

• Apply an ice pack(s) to the area to reduce inflammation and swelling and thereby decrease the pain. Use the ice pack(s) for periods of 20 to 30 minutes with at least a 30-minute interval between each application.
  
• If you have insidious, recurring pain, apply moist heat to the back of the neck, arm and shoulders. Use the heat for periods of 20 minutes with at least a 30minute interval between each application. A word of caution: these are temporary remedies and not a substitute for seeking immediate professional evaluation and care.
  

What Can the Doctor of Chiropractic Do to Help?
Doctors of chiropractic are educated and trained in the detection and care of problems related to the spine. Your first visit to the chiropractor will include a complete chiropractic examination. X- rays may be ordered to screen for possible underlying pathologies and to reveal extreme distortions of the spine.

If your doctor of chiropractic feels that chiropractic care is appropriate in your case, he/she may give you an adjustment to help reduce the misalignments and ease the pressure on the spinal nerve roots. In addition your chiropractor may advise you on therapeutic exercises, job safety, work-related posture and dietary information.

What Can I Do to Prevent Arm and Shoulder Pain?
Your doctor of chiropractic cannot correct pain in the arm and shoulder without your help. These steps can help:

• Don't sleep on a stack of pillows, or even one thick pillow. By doing so you can put stress on the upper back and neck.
  
• Don't read or watch television while lying down. This can contort the neck. Always sit upright.
  
• Don't carry heavy purses or bags with a shoulder strap. The weight can pull on the neck and shoulder causing further pain.
  
• When doing work that requires you to bend your neck downward or face the same direction for long periods take frequent breaks.
  
• Be strict in following good postural habits when standing, sitting and walking.
  
• Follow a regular schedule of appropriate exercises to help strengthen your back and neck. Your chiropractor can recommend the best exercise program for you.