How To Crack Between Neck And Shoulder
Maricel Fergason
Surgery. If your neck and shoulder pain persist for months and nothing else eases your discomfort, your doctor may recommend surgery. Surgical repair of a condition such as a herniated disk in the neck or torn rotator cuff in the shoulder may be what it takes to get you back to being pain free.
Sam Farres, M.D., Chair, Division of Vascular Surgery Mayo Clinic in Florida: Thoracic outlet syndrome is a condition where irritation or compression of nerves and vessel can happen within the thoracic outlet. And the thoracic outlet is the space between the collar bone and the first rib. So when this irritation or compression happens, it causes different kinds of symptoms that can be nerve in nature or vessel-related in nature and that's what caused the thoracic outlet syndrome phenomenon.
Thoracic outlet syndrome (TOS) is a group of conditions in which there's pressure on blood vessels or nerves in the area between the neck and shoulder. This space is known as the thoracic outlet. Compression of the blood vessels and nerves can cause shoulder and neck pain. It also can cause numbness in the fingers.
Common causes of thoracic outlet syndrome include trauma from a car accident, repetitive injuries from a job or sport, and pregnancy. Differences in anatomy, such as having an extra or irregular rib, also can cause TOS. Sometimes the cause of thoracic outlet syndrome is not known.
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Thoracic outlet syndrome is often caused by compression of the nerves or blood vessels in the thoracic outlet, the area between the neck and shoulder. The cause of the compression varies and can include:
Complications from this condition stem from the type of thoracic outlet syndrome. If you have swelling or a painful discoloration in the arm, it is important to seek urgent medical attention. You may need treatment for blood clots or an aneurysm.
For neurogenic TOS, repetitive nerve compression can result in long-term injury resulting in chronic pain or disability. Neurogenic TOS can be confused for other joint or muscle injuries. If symptoms don't improve, it is important to seek medical attention for an evaluation and testing.
If you're at risk of thoracic outlet compression, avoid repetitive movements and lifting heavy objects. If you're overweight, losing weight may help you prevent or relieve symptoms of thoracic outlet syndrome.
Even if you don't have symptoms of thoracic outlet syndrome, avoid carrying heavy bags over your shoulder. This can increase pressure on the thoracic outlet. Stretch daily, and do exercises that keep your shoulder muscles strong and flexible.
Marjorie Hecht is a longtime magazine editor/writer, now working as a freelancer on Cape Cod. Her specialties are science, technology, and medicine, but her eclectic career includes being a reporter at the United Nations and covering politics in Washington, D.C. She has an MSW from Columbia University, a BA from Smith College, and she did postgraduate work in race and demography at the London School of Economics.
Catherine Lovering holds a law degree (LLB) from the University of Victoria. She has been a freelance writer since 2010 writing about health and other people-focused issues. Catherine is currently completing a Philosophy and Psychology combined degree at UBC in Vancouver, British Columbia.
Neck and shoulder pain is often due to an injury of the soft tissue. Soft tissue includes your muscles, tendons, and ligaments. The term is used to distinguish it from the hard tissue of bones and cartilage.
A doctor may also refer you to a physical therapist who can work on your soft tissue and muscles to ease the pain. The therapist can give you a home exercise routine tailored to your needs. This will help strengthen your neck and shoulders to prevent a future injury.
Pain felt in the shoulder area can sometimes be coming from your neck. This is because the nerves and muscles that arise from your neck pass through your shoulder on their way down the arm. The nerves from your neck (Nerve Roots) also travel down your arm (via the Brachial Plexus). Thus neck pain may extend down your arm.
The pain is NOT made worse with movement of your shoulder, so your shoulder moves freely without aggravating the pain. This is the simplest way to know that the pain is not from your shoulder, but from your neck!
However, it can become confusing because many people with neck-related shoulder pain also develope weakness of their shoulder rotator cuff muscles and get subacromial impingement of the shoulder. It takes an experienced clinician to help you to differentiate the two sources of pain.
If the pain is from your neck joints (cervical spine) and ligaments the pain is often a dull ache. If the pain is from a trapped nerve then the pain can be very, very severe. You may also get pins and needles or numbness in your hand. This is typically in the distribution of the affected nerve (known as a dermatome).
The common causes of shoulder pain from the neck are:
- Cervical spondylosis - arthritis of the spine
- Spinal Stenosis - narrowing of the spine, usually due to arthritis
- Disc prolapse - the spongy disc is pushed backward and presses on the nerves to your arm. This can be very painful.
- Ligament or muscle injury - usually after a fall or motor accident.
Therefore, an experienced shoulder or neck specialist is needed to assess both your neck and shoulder to differentiate between the two. Neck and shoulder specialists often work together to optimally treat the pain.
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Objectives: Prolonged sitting has been suggested as a risk factor for neck-shoulder pain (NSP). Using a cross-sectional design, we investigated the extent to which objectively measured time sitting is associated with NSP among blue-collar workers.
Results: For total sitting time, workers in the high sitting category were more likely (adjusted OR 2.97, CI 1.25-7.03) to report high NSP intensity than those who sat moderately (reference category). Low sitting during work was associated with a reduced NSP intensity, but only for males (adjusted OR 0.26 CI 0.07-0.96). No significant association was found between sitting during leisure and NSP intensity.
Conclusion: These findings suggest an association between sitting time, in total per day and specifically during work, and NSP intensity among blue-collar workers. We encourage studying the structure and explanation of this association further in prospective studies on larger populations.
When neck pain and shoulder pain occur together, some people may find the neck pain more concerning. For others, the shoulder pain may be more painful or limit more activities. Depending on the cause of the pain, it is also possible for the neck and shoulder pain to alternate in intensity during different activities.
A facet joint can become a source of pain if its protective cartilage starts to wear down or the joint capsule gets a tear. As the joint degenerates, bone spurs grow to stabilize the joint, increasing inflammation and stiffness.
These degenerative changes to discs and facet joints in the cervical spine can cause a nerve root to become compressed which can result in cervical radiculopathy symptoms of pain, tingling, numbness, and/or weakness to radiate down the arm.
Similarly, degenerative changes to discs and facet joints can also cause the spinal cord to become compressed resulting in cervical myelopathy symptoms of severe shooting pains, weakness, and/or reduced coordination anywhere beneath the level of spinal cord compression.
In the cervical spine, there are six discs that lie in front of the spinal column and connect each of the 7 cervical vertebrae. Each disc is made up of a soft inner gel-like material called the nucleus pulposus that is encapsulated by a series of tough outer fibrous bands called the annulus fibrosus.
In the cervical spine, discs tend to herniate to the side, or laterally, causing irritation to a nerve root on one side. The two most common levels in the cervical spine to herniate are the C5-C6 level and the C6-C7 level.
In severe cases, spondylosis can cause myelopathy, which is spinal cord compression that results in neurological deficits. When myelopathy is caused by cervical spondylosis, it is called cervical spondylotic myelopathy. It can be caused by many factors, such as degenerating discs and facet joints, enlarged bone spurs, and ligament thickening.
Cervical spondylosis with myelopathy may worsen over time. If the spinal cord becomes compressed within the cervical spine, pain or neurological deficits, such as numbness or weakness, may be experienced in the arms, legs, or anywhere below the level of compression.
Degeneration in the cervical spine, also called cervical spondylosis, can involve cervical osteoarthritis, cervical degenerative disc disease, and other wear-and-tear conditions of the spine. As the spine eventually starts to degenerate with age, one or more intervertebral foramen (bony openings where the spinal nerves exit the spinal canal) may become smaller, called foraminal stenosis. With less room, a spinal nerve may become compressed or inflamed, causing pain to radiate from the neck down into the shoulder.
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