Shoulder Nerve Pain: Symptoms, Causes And Treatment Options

Shoulder nerve pain is an umbrella term that describes the deep achy discomfort, neural tightness, muscle weakness, and burning sensations that can occur in the shoulder area. Nerve pain in the shoulder blade typically most commonly happens from irritation or compression of the nerve root as they leave the spinal cord.

Compression of the nerves can also occur as the nerve passes through the shoulder. This can result from various factors, including bone spurs and other bone deformities, old scar tissue causing adhesions around the nerve or postural collapse, decreasing the space that the brachial nerves (nerve bundle in the shoulder) pass through.

What is shoulder nerve pain?

Shoulder nerve pain causes severe shoulder, arm, and hand pain. Inflammation or irritation of your shoulders or neck nerves commonly causes it. The pain can be felt anywhere along your upper back and neck and down to the front of your chest, arm, and shoulder.

A brachial plexus injury can also cause nerve pain stemming from the shoulder. These injuries are usually from intense traction stress to the upper arm and often damage the shoulder’s nerves and rotator cuff tendons. These rare injuries result in nerve damage and require a surgical procedure to resolve and heal properly.

Common Causes of Shoulder Nerve Pain

  • Rotator cuff injuries: Rotator cuff tears (injuries) can cause shoulder nerve pain, especially among people who carry heavy objects or perform repetitive activities that strain their shoulders. These injuries can cause local scar tissue that can affect the nerve pathway and cause irritation on the nerve. Rotator cuff injuries are common and don’t always have to be associated with trauma.
  • Shoulder impingement syndrome: This condition occurs when the tendons and bursa rub against bones in your shoulder joint or subacromial space. This can cause inflammation and irritation, which affects the nearby nerves and can cause patients to hold their shoulders in unusual positions, which may cause more pressure on the nerves.
  • Bursitis: Inflammation of one or more bursae can also lead to shoulder nerve pain by pinching nerves as they travel through them during movement. This is much less common as a direct cause of nerve impingement but is very commonly seen alongside nerve pain in the shoulder.
  • Tendonitis: Tendons are bands of tissue that connect muscles to bones. They’re responsible for movement at each joint in your body–including those in your arms and hands. Tendonitis happens when they become inflamed due to overuse or injury. Tendonitis, like rotator cuff injuries, can irritate the bundle of nerves called your brachial plexus as they pass through the shoulder.
  • Pinched nerve: A pinched nerve refers specifically–but not exclusively–to compression of the nerve as it exits between two vertebrae in the spine. The most common cause for this compression is a cervical disc bulge. This compression can cause symptoms of sharp pain, numbness, and tingling in the arms and hands. A pinched nerve will also often have neck pain, muscle atrophy and persistent pain much more stubborn than nerve pain that occurs primarily through the shoulder.
  • Frozen shoulder syndrome: Frozen shoulder syndrome is when your shoulder joint becomes stiff, painful, and difficult to move. It typically develops after an injury or surgery on your arm, but it can also occur for no apparent reason. As the capsular tissue of the shoulder thickens, it becomes tough for the nerves to glide smoothly through the shoulder. Initially, there will only be nerve pain with movements towards the ends of the range as the nerve begins to be tugged on through the adhered, thickened shoulder tissue. Eventually, as the frozen shoulder progresses, pain can become constant as the nerve becomes compressed by the thickening tissue.

Symptoms of Shoulder Nerve Pain

Symptoms of shoulder nerve pain can be very similar to other conditions, such as bursitis, tendonitis, or rotator cuff injuries. There may also likely be more than one issue or injury co-occurring, so please only use these symptoms as a guide and get a physical examination by a registered practitioner if you think you may have nerve pain in your shoulder.
Symptoms include:

  • Pain in the shoulder (sharp, shooting, dull severe ache)
  • Pain that worsens with activity, especially overhead activity
  • Numbness and tingling in fingers on the same side as the affected shoulder
  • Pain radiating down into the arm
  • Weakness in hand and fingers on the same side as the affected shoulder
  • Loss of coordination or control of fine movements of the hands

 

The pain can be constant or intermittent, often described as dull aches. Shoulder nerve pain can be difficult to pinpoint its exact location because it is felt in the affected nerve distribution. The symptoms often worsen with any movement that stresses the shoulder joint, such as reaching overhead or lifting something heavy. Pain will often worsen later in the day as the neck and shoulder movement has irritated the affected nerve throughout the day.

The pain pattern of your issue will tell a specialist a lot about where the nerve compression is likely happening, so be sure to take note of when your nerve pain is worst and what seems to aggravate it.

Osteopathy and Shoulder Nerve Pain

An experienced osteopath can diagnose the cause of shoulder nerve pain and treat it with gentle hands-on techniques.

The first step is an accurate assessment of the problem using a combination of clinical tests, such as palpation (feeling for areas of tension in the body) and joint range of motion testing, orthopaedic tests to put stress on different structures in the neck and shoulder, and muscle strength testing with the use of a dynamometer.

Diagnosis may also include referral for an MRI (magnetic resonance imaging) or a nerve conduction study. These tests and a comprehensive medical history will help your osteopath identify the likely root cause of the nerve pain in your shoulder.

In the case of shoulder nerve pain, treatment may include a combination of techniques that address the underlying structural problems causing or contributing to your pain. These may include gentle soft tissue massage, stretching exercises, spinal manipulation to the upper back, acupuncture or dry needling, or other modalities appropriate for your condition.

Suppose physical therapy is not resolving the nerve pain, or the nerve pain is too severe for conservative treatment. In that case, your osteopath may work with your doctor and advise a cortisone steroid injection to help ease local inflammation in the neck or shoulder and, if severe enough, a referral to a neurosurgeon.

Exercises to Help Shoulder Nerve Pain

You can do some exercises to help relieve shoulder nerve pain. The following video demonstrates techniques called flossing that help gets the nerve moving freely in the shoulder and can reduce pain:

  • radial nerve flossing
  • ulnar nerve flossing
  • median nerve flossing

 

The video below will show you how to do each of these exercises.

Prevention and Management of Shoulder Nerve Pain

Maintain good posture

Maintaining good posture is one of the best ways to prevent shoulder pain. If you slouch, it can put pressure on your nerves and cause them to become inflamed.

Avoid environments where you are slouched or hunched for too long. If this can’t be avoided, include enough movement in your day to offset this passive position.

If you think this contributes to your condition, ask your osteopath for advice on alterations to your environment or workplace or some stretches and exercises that may help reduce the strain from these environments.

Strengthen the shoulder muscles

The rotator cuff muscles stabilise the shoulder joint. Strengthening these muscles can help relieve some of the stress off your nerves, relieving pain. The exercises help stabilise the shoulder focus on control and form.

Ask your osteopath to give you some exercises specific to you that may help make your shoulder more resilient and reduce the strain placed on the brachial nerves.

Our favourites in the clinic are shoulder exercises using a theraband. Therabands are great for easy, adaptable, mobile exercises you can do anywhere.

Avoid overuse

Excessive use of your shoulder can also cause pain and injury. As we have explored in this blog, injury to the neck or shoulder is the most common onset of nerve pain.

Overuse injuries are often due to repetitive movements like typing, work-related actions (imagine a bricklayer laying 1000’s bricks a day), or training in the same exercise or activity for a sport.

If you’re concerned that you may suffer from overuse syndrome, try taking a break from the activity for a few days to see if it helps relieve your symptoms.

Conclusion

If you’re experiencing shoulder pain, it’s essential to seek treatment from a healthcare practitioner. This treatment can help determine the cause of your symptoms and offer the most appropriate treatment options.

If you have questions about your shoulder pain or are concerned that you may suffer from a more severe condition, such as a cervical disc bulge or rotator cuff tendonitis, please consult your doctor or osteopath immediately.