Shoulder and arm pain can come from several different sources. Injury in the neck or upper body can cause pain referral into the shoulder and arm, or injuries of the muscles, nerves, joints and ligaments of the arm and shoulder can be injured directly.
Often pain referring down the arm is blamed on a “pinched nerve”. Nerves can be “pinched” in the neck/upper back from a disc injury, with osteoarthritis and degenerative changes or from an injury.
- typical nerve pain is severe and sharp/stabbing
- can cause numbness, total loss of feeling or weaknesses
- true nerve compression is not very common. More often pain referral stems from muscle, joint and disc problems
- even if the nerve is not being directly compressed the pain can still be severe
The arm, shoulder and hand contain over 40 different muscles. Muscle strains are very common, especially following physical activity.
- pain can range from minor stiffness to severe pain
- pain often triggered with stretching or resisted activity
The shoulder is a highly mobile joint -- and therefore has a high risk of injury.
Shoulder dislocation or instability
- typically results from a fall or trauma
- may feel shoulder "going out of joint" with certain movements
- adhesive capsulitis
- progressive loss of shoulder mobility in almost all directions typically following an injury
- untreated may take 4 years to improve (and still not fully recover)
- often attempt treatment with cortisone injections or medications -- but this only obscures symptoms for a short period.
- muscles stabilizing and supporting the shoulder joint are at high risk of injury -- acute injury or repetitive strain can lead to "tendinopathy"
- important to properly retrain the muscles to avoid re-injury
- can also include bursitis (irritation of the lubricant fluid sac)
The ac joint is an attachment between the collarbone and shoulder blade
- typically traumatic onset
- injury can damage stabilizing ligament
The most common injury around the elbow is referred to as "tennis elbow" with pain on the outside of the elbow (a similar problem "golfers elbow" is on the inside")
- technically a tendinopathy (chronically irritated tendon tissue)
- repetitive strain injury
- pain with resisted movements and even light activities
- often becomes very chronic -- but can resolved with conservative treatment rather than injections that just mask the pain
Wrist and hand pain
Carpal tunnel syndrome is a common cause of wrist and hand pain.
- weakness in the hand and numbness in the 1-4th digits
- typically triggered from repetitive strain and irritation in the tendon of the wrist
- often recovers with conservative treatment rather than surgery
Treatment must always start with an appropriate diagnosis.
Treatments should focus on the underlying cause of the pain - both the tissue causing the pain as well as the factors triggering the problem. A combination of treatments, such as, massage, soft tissue treatments (Graston), manipulation/mobilization and/or home stretching exercises can be effective ways to reduce the tissue irritation.
We identify any aggravating factors and help you manage any issues through a program of self-care and prevention.
For a clinical assessment of your arm and shoulder pain, the triggers and best treatment options, please contact Bedford Chiropractic for an appointment.