Causes of a Pinched Nerve in The Shoulder

It can be difficult to figure the causes of a pinched nerve in the shoulder because there are many options. In this post I’ll explain the most common causes of a pinched nerve feeling in the shoulder. Additionally, I will do a review of the less common causes. I’ll also explain why you’re getting sharp, shooting, or tingling pain in your shoulder.

First of all, let me explain the symptoms of a pinched nerve in the shoulder…

Although it may feel like the shoulder has a pinched nerve, these symptoms are usually coming from the neck. It may be better described as a pinched nerve in the neck. Even the term “pinched nerve” can be debated, since the nerve is usually not pinched like a garden hose. I don’t really like that term, although that’s the term you usually hear. Instead, the nerve is inflamed, irritated, or compressed. A better term for these symptoms are an irritated nerve or nerve root.

What Are The Most Common Causes of a Pinched Nerve in the Shoulder?

The symptoms of a pinched nerve in the shoulder are commonly caused by the following causes. These are in no particular order, but I will make some comments as to the most likely causes in the descriptions.

Cervical Radicular Pain – This is when a nerve root in the cervical spine (neck) is inflamed or compressed. A nerve root is the part of the nerve that exits the spine through a small hole, called an IVF. There are a number of issues that can cause the nerve root to become inflamed or compressed (which I cover below) and lead to pain in the shoulder and arm.

Cervical Radiculopathy – This condition is similar to cervical radicular pain, but more advanced. In addition to pain along the path of the nerve there are other signs and symptoms. In cervical radiculopathy you may have numbness, diminished or absent reflexes, and muscle weakness in addition to pain. The issues that cause cervical radiculopathy are often the same as those which cause cervical radicular pain.

What Leads to Cervical Radicular Pain and Cervical Radiculopathy?

The above conditions usually don’t develop without an underlying cause. These are the common causes of cervical radicular pain and cervical radiculopathy:

Cervical Disc Herniations or Disc Bulges – Disc injuries to the neck occur when the outer layer of the disc stretches or breaks. This process creates inflammation near the disc problem, which is typically close to a cervical nerve root. With inflammation in this area the nerve root is subsequently irritated and often causes symptoms of a pinched nerve in the shoulder.

Lateral Canal Stenosis – This happens when the canals where the nerve roots exit narrow. Narrowing is caused by spinal osteoarthritis, also called degenerative disc disease or degenerative arthritis. Essentially what happens is bone grows around the canal creating a narrow canal. Subsequently it becomes easier to irritate the nerve root with simple neck movements, like looking over your shoulder.

Nerve Root Traction Injuries – You can often identify if you had one of these and it’s the cause of your shoulder pinched nerve symptoms. These happen when your nerve is stretched quickly, like during trauma. A common example would be your head moving quickly one direction and your arm moving down and the opposite way. This creates a quick stretch on the nerve and subsequent nerve fiber trauma.

Spinal Osteophytes (Bone Spurs) – These are outgrowths of bone that can rub up against a nerve root and cause cervical radicular pain and cervical radiculopathy. Bone spurs in the neck are another sign of osteoarthritis of the spine.

Central Canal Stenosis – This happens when the canal for the spinal cord narrows due to bony growth. Central canal stenosis usually causes radicular symptoms into both arms and is a more serious condition that develops over time.

What are Other Causes of a Pinched Nerve in the Shoulder?

Thoracic Outlet Syndrome (TOS) – TOS develops when the brachial plexus, a bundle of nerves that originate in the neck, are compressed or irritated. The brachial plexus irritation is usually caused by the pectoralis minor muscle, scalene muscles, or by a cervical or 1st rib.

Perineural Cyst (Tarlov Cyst) – These are cysts that develop after shock, trauma, or exertion of the spine. A fluid filled sac develops that can impinge on the nerve root. These are a less common cause of pinched nerve symptoms.

Spinal Pathology – Pathology to the spine includes infection, benign tumors, and malignant tumors of the spine. These are not a common cause of pinched nerve symptoms in the shoulder and make up a very small quantity of cases. There are typically other abnormal signs and symptoms that chiropractors screen for to rule this out.

Spine Trauma – Compression fractures of the spine and vertebral fractures are conditions that can occur after traumatic injury and cause pinched nerve symptoms. Compression fractures can also happen in those with low bone density and without identifiable trauma.

Is it Good to See a Chiropractor for a Pinched Nerve in the Shoulder?

A chiropractor is a good doctor to see for a pinched nerve in the shoulder. I’d argue chiropractors are the best doctors to see for a pinched nerve in the shoulder. Chiropractors are experts in muscle, joint, and nerve issues related to them. A pinched nerve is exactly that, a nerve being affected by faulty movement in the muscles and joints, especially the spine. Here’s how I would typically treat this complaint:

• Do a thorough exam and movement assessment to figure out what’s causing the pinched nerve symptoms.
• Use mobilization or manipulation to restore motions to joints that are causing your symptoms.
• Soft tissue release to relieve pressure your dysfunctional muscles are placing on the nerve and joint.
• Design a specific exercise program to relearn normal movement patterns that are at the root of the problem.
• Use acupuncture or dry needling to eliminate muscle knots or trigger points that mess up muscle function and movement.

The vast majority of pinched nerves in the shoulder will respond well to these treatments and improve. By seeing a chiropractor first you’re taking actions to fix the underlaying cause. Medications and injections have their place in severe cases, stubborn cases, and more complex cases but aren’t going to fix the root cause. If your pain and movement aren’t improving, I typically refer patients to orthopedics, neurosurgery, or pain management. I want you to get better, even if I’m not the one who can do that for you.

Looking for more information on a pinched nerve in the shoulder? See some of my other content on this condition here!

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