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Severe neck pain radiating down to shoulder and arm
What causes severe pain to radiate from neck down to shoulder and arm and prevent a person from raising his or her arm above their shoulder, except if they are lying down with back against the mattress?
A related discussion, Severe Pain in Neck and Shoulder radiating down to arms. was started.
MEDICAL PROFESSIONAL
Hi
Welcome to the MedHelp forum!
Your symptoms could be due to three main possibilities. One is a pinched cervical or upper thoracic spinal nerve. The other possibility is Scalene Myofascial Pain Syndrome (SMPS). When scalene muscle is the cause of pain, the pain is referred chest, inner lining of scapula, shoulder, posterior and lateral sides of the arm right up to the thumb and index finger. When this muscle shortens, this can press on brachial plexus and the subclavian artery and can compress or irritate these structures and cause symptoms such as abnormal sensation, cold extremity, claudication, and lymphedema in the involved extremity. The third possibility is TOS or thoracic outlet syndrome which occurs as the result of narrowing of space below and behind the collar bone. You probably have neurogenic variant of TOS characterized by non specific symptoms like neck stiffness, pain on raising the arm above the head, neck pain and headaches and a tired feeling in arm. SMPS is also a major cause of TOS. It is difficult to comment beyond this at this stage. Do consult your PCP and get a referral for a neurologist. You may need MRI and CT scans for diagnosis. Please let me know if there is any thing else and do keep me posted. Take care!
Welcome to the MedHelp forum!
Your symptoms could be due to three main possibilities. One is a pinched cervical or upper thoracic spinal nerve. The other possibility is Scalene Myofascial Pain Syndrome (SMPS). When scalene muscle is the cause of pain, the pain is referred chest, inner lining of scapula, shoulder, posterior and lateral sides of the arm right up to the thumb and index finger. When this muscle shortens, this can press on brachial plexus and the subclavian artery and can compress or irritate these structures and cause symptoms such as abnormal sensation, cold extremity, claudication, and lymphedema in the involved extremity. The third possibility is TOS or thoracic outlet syndrome which occurs as the result of narrowing of space below and behind the collar bone. You probably have neurogenic variant of TOS characterized by non specific symptoms like neck stiffness, pain on raising the arm above the head, neck pain and headaches and a tired feeling in arm. SMPS is also a major cause of TOS. It is difficult to comment beyond this at this stage. Do consult your PCP and get a referral for a neurologist. You may need MRI and CT scans for diagnosis. Please let me know if there is any thing else and do keep me posted. Take care!
What you have is a "pinched" nerve in the cervical vertebrae.
Generally this is due to an inflamed, swollen or degenerated disc. This degeneration could be due from an injury or a disease process.
This brings us to a decision point:
Can the condition be improved by therapy or is the degeneration due to a disease process that cannot be reversed?
Hmmmmm....
This is not always an easy call, because there are sometimes elements of both. A bit of arthritis and an old subluxion injury from sudden head flexure, for example.
A good physician should be able to identify the nerve by the pain dermatome, but an MRI is warranted. Not a CT.
Do not go to a chiropractor. An x-ray is fundamentally worthless. The only proper diagnostic evaluation is with an MRI.
Ultrasound treatment or vibratory treatment or neck massage is contraindicated.
Warm compresses will help.
Do not use a cervical collar. Many physicians prescribe this treatment, and it is inappropriate. It will cause rapid atrophy of the musculature that causes the head to be supported. The result will be more pressure on the nerve. More pain.
For the same reason a neck brace is contra-indicated.
Get an inflatable cushion to sit on in a car and avoid riding in a vehicle such as a truck where there are "up-and-down" bumps.
By the same token do not take muscle relaxants. They will cause the musculature to become flaccid and again put pressure on the disc and nerve.
Do not take oxycontin or an opiate. The pain receptors are different. You will only end up with a drug habit.
Definitive treatment involves several days or oral prednisone, which has to be by prescription.
And then daily treatment with mild axial traction.
An axial traction device can be purchased for $35-$40 U.S. You throw away the water bag and set it up to a cup hook in the beam under a door. Lower yourself gently (but don't hang yourself) until you feel your head being pulled strongly upwards along the axis of the spine. You need fifteen minutes sessions every two hours initially, plus the anti-inflammatory, and after a day begin range of motion exercises, rotating the head three hundred and sixty degrees (I know you can't do this in actuality - you sort of roll it around) through the limits of pain.
When the situation clears you keep the traction device and may have to use it once a week or so, whenever the symptoms return. You can then use ibuprufin as the anti-inflammatory drug.
Normally, this treatment will provide resolution unless you have degenerative arthritis, or a secondary condition that is causing deterioration of the cartilidge. An MRI will help in differential diagnosis. A 1T MRI should be adequate.
You also want to keep well hydrated and avoid high glucose meals. High glucose levels affect osmolality and this causes more pain.
Generally this is due to an inflamed, swollen or degenerated disc. This degeneration could be due from an injury or a disease process.
This brings us to a decision point:
Can the condition be improved by therapy or is the degeneration due to a disease process that cannot be reversed?
Hmmmmm....
This is not always an easy call, because there are sometimes elements of both. A bit of arthritis and an old subluxion injury from sudden head flexure, for example.
A good physician should be able to identify the nerve by the pain dermatome, but an MRI is warranted. Not a CT.
Do not go to a chiropractor. An x-ray is fundamentally worthless. The only proper diagnostic evaluation is with an MRI.
Ultrasound treatment or vibratory treatment or neck massage is contraindicated.
Warm compresses will help.
Do not use a cervical collar. Many physicians prescribe this treatment, and it is inappropriate. It will cause rapid atrophy of the musculature that causes the head to be supported. The result will be more pressure on the nerve. More pain.
For the same reason a neck brace is contra-indicated.
Get an inflatable cushion to sit on in a car and avoid riding in a vehicle such as a truck where there are "up-and-down" bumps.
By the same token do not take muscle relaxants. They will cause the musculature to become flaccid and again put pressure on the disc and nerve.
Do not take oxycontin or an opiate. The pain receptors are different. You will only end up with a drug habit.
Definitive treatment involves several days or oral prednisone, which has to be by prescription.
And then daily treatment with mild axial traction.
An axial traction device can be purchased for $35-$40 U.S. You throw away the water bag and set it up to a cup hook in the beam under a door. Lower yourself gently (but don't hang yourself) until you feel your head being pulled strongly upwards along the axis of the spine. You need fifteen minutes sessions every two hours initially, plus the anti-inflammatory, and after a day begin range of motion exercises, rotating the head three hundred and sixty degrees (I know you can't do this in actuality - you sort of roll it around) through the limits of pain.
When the situation clears you keep the traction device and may have to use it once a week or so, whenever the symptoms return. You can then use ibuprufin as the anti-inflammatory drug.
Normally, this treatment will provide resolution unless you have degenerative arthritis, or a secondary condition that is causing deterioration of the cartilidge. An MRI will help in differential diagnosis. A 1T MRI should be adequate.
You also want to keep well hydrated and avoid high glucose meals. High glucose levels affect osmolality and this causes more pain.
Sounds like you have nerve pain due to a disc. Try an anti-inflammatory such as alieve or advil, this may bring a little relief but i would go see a doctor. Get a referral to a neuro. I had a ruptured disc and at first thought is was something wrong with my shoulder and arm, but then the pain got worse and was in my neck and the back of my head. i couldn't hardly use my right arm until i had cervical epidural injections (1 a week for 3 weeks) not a comfortable procedure but relieved pain and give back use of my arm. Good luck. I hope you get some relief soon.
Should be checked out by Dc but might be same as me, degenerative disc. Can be very painfull and many days worse than others, comes on for no reason and sometimes very suddenly and stays. A good chriopratic Dr will help if that is what it is but you will have to go on a regular baises to keep the relief you get. It also might be a hyrniated disc and if it is rest and therpy will help but no chiropractor for that. really should get x-ray
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