Shoulder Abduction Relief SAR

NECK AND ARM PAIN

keywords: shoulder abduction relief, pinched nerve, chiropractic help, arm pain

 Does placing your hand on your head relieve your 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 ...



IMPORTANT CONSIDERATIONS




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. 



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. Mrs D, a 78 year old woman has very severe sacroiliac joint pain, and even more severe cramps in her right leg. There are two problems; she is on two diuretics but no slow K. Taking her temporarily off one diuretic and adjusting the SIJ brought 50 percent relief within four days. 

2. Mr S, a 48 year old man, has right low back pain, groin pain and a numb feeling in his lower leg when he sports. For six months he's been off football. He too has two problems; a very treatable lumbar facet syndrome and a very serious blocked artery in the groin; it's called intermittent claudication. Smokers beware.  

3. Mr S looks like the leaning tower of Pisa; he has a slipped disc at L5 making him lean towards the opposite side. It's called the postero lateral disc hernia; we'll fix it, but he has to stop for a week or two. Antalgias are serious so take them seriously. 

4. Mrs V too has  two conditions; a chronic low grade sciatica giving her an ache in the right leg, and a threatening Morton's neuroma. She's glad I'm back in Holland; chiropractic fixed it before, and we'll fix it again. 

5. Mrs W is one of the lucky ones, says her doctor. I agree. He says only 40% of patients with lumbar stenosis have a successful operation. We fixed a nasty slipped disc three years ago, but it came back two years later; the surgeon did a fine job but she has a weak ankle now giving her subtalar joint pain; it's routine stuff. 

6. I myself had an acute exacerbation of a femoral nerve lesion last year. One immediate treatment of the new strain by my colleague has fixed the pain in the lower back, but there's some residual numbness in the lower leg; no soaring tomorrow alas.

7. This lady is a 86 year old woman with a 63 scoliosis. Chronic lower back has been her lot in life but she's well pleased with chiropractic and comes for chiropractic help once a month; some conditions you can never cure.

8. She is an 78 year old woman, is doing remarkably well with a bad sciatica. But over 200 pounds she is not losing weight; in fact, gaining despite my suggestions. She's high risk for a stroke. I have referred her to a dietician to crack the whip.

9. A 61 year old man with upper cervical pain yesterday; it's not severe but also not getting better of its own accord. He's afraid it may turn very acute as when I treated him three years ago. Since then it's been fine. 

10. A 64 year old woman has had scheuermanns disease; it's left her with a spinal kyphosis and chronic middorsal pain. She responds well to chiropractic treatment provides she come every six weeks or so for maintenance treatment.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

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. Mrs B has had one of the nastiest of conditions; vertigo caused by a disturbance in the inner ear. Falling repeatedly and vomiting she consulted her doctor but medication didn't help. After two sessions of the Epley manoeuvres she was 50 percent better. After two weeks 75 percent improved. No longer vomiting all falling. She's not enjoying the Brandt Daroff home exercises.

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.



Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?


Interesting questions from visitors

CLS writes:

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.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.