Although nerve impingement can occur in the shoulder, a more common origin of shoulder and arm pain is the cervical spine or neck, where the nerve root--an offshoot of the spinal cord--exits the spine between two vertebrae and heads toward the shoulder. Reasons for a pinched nerve include disc herniations, degenerative joint disease and spinal stenosis. Remedies for a pinched nerve causing shoulder pain are equally diverse.
Neck Exercises
According to the Hospital for Special Surgery--a New York City hospital that specializes in orthopedic surgery--when the pain associated with cervical radiculopathy or a pinched nerve is reduced, range of motion and strengthening exercises can help restore neck and shoulder structures that have been weakened by disuse and pain. Some health care practitioners recommend McKenzie exercises--named after Robin McKenzie, the technique's founder--for their patients with cervical radiculopathy. McKenzie exercises, while often used to treat low back pain, can also be used to treat neck pain. They involve repetitive motion in a specific direction. According to the Spine Health website, patients and practitioners using the McKenzie technique search for a directional preference with neck movement that helps centralize the patient's pain over the problematic area. Performing this motion regularly may abolish the pinched nerve-related arm and shoulder pain.
Traction
Most patients with a pinched nerve that causes shoulder pain benefit from traction therapy. According to the Spine Health website, low-weight cervical traction may be helpful in the initial treatment phase of a pinched nerve caused by an intervertebral disc herniation. Although there are numerous traction devices used by patients and practitioners in the office and at home, the usual course of treatment involves 7 lbs. to 10 lbs. of traction applied for one hour, three times per day. According to the Neck Solutions website, neck traction can help reduce the mechanical irritation on the involved nerve root or dorsal root ganglion by separating the vertebrae and decompressing those structures. Most patients welcome the relief associated with neck traction. Patients who suspect they have a pinched nerve should talk with their physician to see if traction therapy is appropriate.
Spinal Manipulation
According to a 2005 study by Joshua A. Cleland, DPT, and colleagues published in the Journal of Orthopaedic & Sports Physical Therapy, 91 percent of patients with cervical radiculopathy in their case series reported reduced pain and improved function at the time of discharge and at a six-month follow-up. The patients in this study received a multimodal treatment approach that consisted of strengthening exercises, intermittent cervical traction and manual physical therapy, including spinal manipulation. A 1999 study by J. Herzog published in the Journal of Manipulative and Physiological Therapeutics" concludes that cervical spine manipulation with a patient under anesthesia is a helpful treatment approach for chronic discopathic disease complicated by cervical radiculopathy and cervicogenic headache syndrome. However, the effectiveness of spinal manipulation for cervical radiculopathy is contingent on appropriate patient selection and the proper training of qualified manual medicine practitioners.
References
- Hospital for Special Surgery: Cervical Radiculopathy: Nonoperative Treatments
- Spine Health: Pain Relief from McKenzie Treatment
- Spine Health: Spinal Traction
- Neck Solutions: Pinched Nerve In Neck
- "Journal of Orthopaedic & Sports Physical Therapy;" Patients With Cervical Radiculopathy: A Case Series; Joshua A. Cleland, DPT et al.; December 2005
