Neck and Nerve Issues

Relating the Neck & Shoulder

The supporting muscles of the shoulder blade can be affected by a shoulder injury. These muscles can be stretched or overworked to compensate for the injury. The muscles that attach the shoulder blade to the neck are the most commonly affected. Patients will often have neck pain or spasms in those muscles. Medication, ice, and/or heat can help in the short run. The long-term solution is to heal the shoulder injury.

Can my neck cause problems in my shoulder?

This is a relatively complicated topic. The simple answer is yes.

Muscles attaching to the neck and nerves that come from the neck can often cause shoulder pain and dysfunction. The most common situation is pain in theshoulder that is coming from irritation of the nerves in the neck.

In simple terms, nerves are the body’s version of wire, and carry the electrical signals from the brain that let the muscles perform their action.

Nerves also carry the signals of pain, and send signals of position (where your arm is in space, as compared to your head, for example) to the brain.

In the shoulder, six nerve roots come from the neck. Five of these combine into a nerve center for the shoulder and arm called the brachial plexus. The brachial plexus then gives off multiple nerves that operate the muscles of the shoulder and give sensation to the region.

The two most important nerves to the shoulder are the suprascapular nerve and the axillary nerve. What can make this topic complicated is finding the cause of the irritation to the nerves. This can often involve testing by a neurologist and an MRI.

Fortunately, for most patients, the irritation is transient, and they will not need a neurologist to find the irritation to the nerves.

How Nerve Problems cause Shoulder Problems

This too can be a relatively complicated topic.

It depends if the nerve problem is coming from the neck, the collection of nerves below the collarbone (brachial plexus), or the specific nerves that operate the shoulder (axillary, suprascapular, long thoracic, and dorsal scapular).

Most Common : Irritation of cervical roots (neck nerves)

The most common nerve problem of the shoulder comes from the irritation of the nerves that exit from the neck. This frequently shows up as shoulder pain and/or weakness, and the pain is often described as “burning” pain.

Most patients experience pain which travels down the arm or to the shoulder blade. Sometimes patients will report numbness (pins and needle sensation) in the arm, forearm, or hand. The key to treating this nerve problem is to diagnose the cause of the irritation of the nerves coming from the neck.

Less Common : Irritation of shoulder nerves

Less commonly, the specific nerves that operate the shoulder can be injured. This can happen with a variety of traumas to the shoulder.

The most common is an injury to the axillary nerve when the shoulder dislocates. The axillary nerve operates the large deltoid muscle of the shoulder and one muscle in the rotator cuff. Most of these injuries will make a full recovery with time, but it can take many months.

Least Common: Brachial Plexus

Least common are injuries to the collection of nerves below the collarbone (the brachial plexus). These nerves can be stretched by a trauma, or inflammation or a virus can affect them. The diagnosis of these nerve injuries requires a thorough evaluation by a neurologist. Treatment can be determined after the evaluation by the neurologist. Frequently, the neurologist will test how the muscles are receiving the nerve impulse and how the nerves are carrying the impulse. This testing is called a “nerve conduction study and electromyography” (NCS/EMG).