NECK AND ARM PAIN
keywords: shoulder abduction relief, pinched nerve, chiropractic help, arm pain
Abduction? Simply raising your arm at the side of your body. Abducting the arm, and placing your hand on your head takes the stretch off the nerves running from your neck to your arm. There are five of them, called the brachial plexus. If you have a pinched nerve, then this will RELIEVE the pain in your arm.
If placing your hand on your head INCREASES the pain in the arm, then you probably have a shoulder anatomy problem problem, a frozen shoulder for example, or another condition where the nerve and artery can be affected in the inter scalene triangle.
Aggravate vs Relieve helps in the diagnosis of a slipped disc in the neck.
More usually, shoulder abduction will aggravate the pain in your arm and shoulder. Then it's not a pinched nerve. It more likely to be strained rotator cuff, or a fixated acromioclavicular joint or a frozen shoulder brewing.
The pain from a pinched nerve in the neck may be very severe, a deep numb ache in the arm, often worse at night. The only position to gain relief may be to place your hand on your head, or sleep with your arm under your head.
This is a serious problem. It's best to get to your chiropractor as soon as possible.
Some understanding of the anatomy of neck pain will help your understanding of this nasty condition. The nerve can also be irritated by a first rib subluxation, a slipped disk in the neck, arthritis in the neck, and other conditions like a cervical facet syndrome. Mostly chiropractic is the treatment of choice, though I confess neck pain can be stubborn, particularly in the presence of arm pain and a positive shoulder abduction relief sign.
This is especially true if there's also wear and tear, and old fracture or arthritis of the joints of Luschka. Also known as the paravertebral or uncovertebral joints, they may compromise the inter vertebral foramen through which the nerve root must escape from the spine on it's way to the neck, arm and upper back.
However, these degenerative changes in the neck have usually been present for years. Why do they now suddenly rear their ugly heads? Herein actually lies our salvation. If they were there before the pain started, then they probably aren't the cause of the pain. What's known as an incidental finding. Which explains why many patients with advanced degerative changes in the neck often respond just as well, or badly, to chiropractic treatment, as those without.
Traction may also help as an adjunctive treatment, though the research indicates that on its own traction is not effective.
Again, raising your arm will INCREASE the pain and tingling in your arm. The condition is called a THORACIC OUTLET SYNDROME ...
UPPER LIMB TENSION TEST
The confirmation of a true pinched nerve is done in part with a test called the Upper Limb Tension Test that you can do at home. However, be warned, the diagnosis and interpretation of tests can only be done by a skilled clinician. Your chiropractor! Upper Limb Tension Test ...
Having said that, a true slipped disk in the neck sometimes requires surgical intervention. But in our admittedly biased opinion, always try conservative treatment first.
CERVICAL COMPRESSION TEST
The Cervical Compression Test is another test used to confirm the SAR PINCHED NERVE sign: is this truly a pinched nerve? Watch this
spectacular way of performing this test. Don't miss it ... and watch to
the end. You won't be sorry, I promise! CERVICAL COMPRESSION TEST ...
Upper back pain
Pain between the shoulders and in the upper back can be very difficult to diagnose. It could be a local problem, say a subluxation of the fourth thoracic vertebra. Or, it could be a rib head subluxation. Does deep breathing cause pain?
On the scary side it could be a mastasis from lung or breast cancer, fortunately both rare, but if you've had a mastectomy or are a smoker, then it does need to be kept in mind.
Then it could simply be a muscular problem, perhaps from sitting fro long hours at a computer that is not properly set up. Is your mouse arm supported? Do your fingers point up or down? How are your eyes in relation to the screen. Are you using a laptop when you could be using a pc, or at least a laptop with a full screen and separate keyboard and mouse?
But then it could also be a referred pain from the neck. If the C5 nerve root is affected then deep upper back pain is often the result, mediated via the dorsal scapular nerve, and tingling and pain the outer upper arm. And you may well get shoulder abduction relief.
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The long and the short of it is that a careful and thorough history and chiropractic examination is in order when dealing with lower neck, upper back and arm pain.
They can be excruciatingly painful and frustrating there is often no known cause. You wake up one morning and everything is rosy. You stretch lazily, and bingo, you have severe neck pain. Within a few days or weeks the pain begins to radiate to the upper back, sometimes the chest depending on the nerve root involved, and arm. And, you get relief by placing your hand on your head.
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Interesting challenges of the day
1. Mr B has the trophy for the most acute neck in February. He has quite advanced lower neck arthritis for a forty year old, thanks to a severe fall on the head from a trampoline. But this is upper cervical pain. Right rotation is simply impossible. Luckily he is improving rapidly, eighty percent better he says after three treatments. See cervical facet syndrome.
2. Mrs C is a new patient with a long history of lower back pain, hip pain and pain in both feet. We'll see how we get on, Rome wasn't built in a day.
3. Miss U sprained her ankle two months ago, wearing high heels. She still has severe mid foot pain. Xrays and perhaps a CT scan.
4. Mr V is 86 years old and hurt his back helping his wife into the car. Just one treatment of the sacroiliac joint and he's eighty percent better. It's not always like that.
5. Mr W lay on his back knocking down a pillar. Turning his head causes severe vertigo. He needs the Epley exercises, not pills, research shows. Update, he's fine.
6. Mrs X, a young mother has severe lower back pain, with numbness down the posterior thigh, calf and side of foot. It started after a long drive in the car. Update, she's forty percent less painful after four treatments, but the leg is still numb. Update two; she 60% better, but it's slow and is going to take the full 6 weeks to heal. Further update; a setback, after lifting her child she now has leg pain. It's going to the be difficult.
7. Mrs Y, a 70 year old woman is on maintenance care fo a nasty lumbar stenosis despite having to do everything at home. Her husband has a hospital acquired infection in the shoulder. After 4 operations he is incapacitated and going rapidly down hill.
8. Mrs Z, an 78 year old woman is doing remarkably well with a bad sciatica. But at over 200 lbs she is not losing weight, in fact gaining despite my suggestions. She's high risk for a stroke. Referral to a dietician to crack the whip.
9. Mr A, a 73 year old engineer, still working, is doing fine after a long episode of lower back pain. Some pain on the side of the hip remains after five treatments. Reassured him it's not hip arthritis.
10. Mrs B, a 64 year old woman has had Scheuermanns disease; it's left with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment, provides she come every six weeks or so for treatment.
11. Mr C, a young engineer fell off his mountain bike injuring his cervical spine and pelvis. Luckily both responded very quickly to a few chiropractic adjustments. Update: his neck is sore again. It all goes back to a whiplash injury ten years ago when he was rammed by a fully laden truck carrying a load of stone. Time for Xrays.
12. Mrs D, a middle aged woman with hip pain of one year duration, despite other treatment. Xrays reveal an impingement syndrome and early hip arthritis. There's much to be done.
13. Both Mrs E and I can't believe how much better her lower back and leg pain are. Surgery for a scoliosis and spondylolysthesis three years ago helped greatly for one year. But then her leg went lame and weak. He was responded extremely well despite all expectations.
And so the day goes. Chiropractors shouldn't be treating the elderly? Bunkum.
Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?
Greetings, Dr B.
You helped me quite some time back with a soothing and professional
response which turned out to be exactly correct. I now consult a local chiropractor.
You write a superb newsletter, too.
Your own unresolved problem. Pose a question
Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.
You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.
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