What Causes a Pinched Nerve and How To Treat It

Pinched Nerve

Pinched Nerve

Learn how your neck or shoulder pain may be due to a pinched nerve and what you can do about the pain.

One of the things that we get a lot of questions about is this pinched nerve diagnosis. A lot of folks come in with pain in their neck or down their shoulder blades are told it’s a pinched nerve. This can be caused by sleeping wrong, doing a lot of work at a kitchen table or in a cubicle, or lifting weight in a gym.  Recently many people are working from home in a new “workspace” with poor ergonomics awareness.  Now we have this toothache feeling pain down into the middle back and shoulder blade area. So you go to the internet expecting to find out what nerve is pinched and even find some easy at-home treatments. Only you don’t find “the” nerve because it could be any number of them and based on what nerve it is and what is going on will determine the best treatment.

We often get people in the clinic who have tried to do some of the internet treatments and now feel worse, and this piercing, toothache-like pain is making it more difficult to focus at work or even get restful sleep.

I just did a “Technique Tuesday” video, Which can be found on Youtube, where we went over two new exercises that will help you with that, and a little bit of a description about what this pinched nerve sensation is. So, take a look at that to see if you have any further questions about it.

But I wanted to discuss why it may refer down into the shoulder blade area.

Maybe even out over the top of the upper trap area. And what is it trying to tell us?  And often, we overlook the fact that even though we have pain in one area doesn’t mean that’s where the injury is, or where we should be treating. Oftentimes, we get this referral pain pattern, often nerve-related, yet sometimes it’s related to what they call myofascial pain, which can be from muscle or facial tension that then causes pain to travel. This takes our attention away from the area that’s injured and what needs attention often leading to frustration because no matter how many massages and stretches to the area of pain you do you never get it better.

Sure there might be some relief, even a day of relief, but it never feels like you get to the root cause of the issue. And so, one thing that we do when we get patients who come in with this pinched nerve complaint with pain between the shoulder blades, is screen the cervical spine or neck. The cervical spine is from the base of the head, all the way down to the top of the shoulders. And that’s more commonly where the injury exists is between levels C5, C6, and C7

.Spine

Why am I Experiencing this Pain?

What we wanna look at is what neck posture causes this pain to occur or to increase. And so, we look at what positions or patterns exist that caused the pain to get worse. Often it’s:

  • Sleeping
  • Sitting for a long period of time
  • looking down at your phone for a long time

Sometimes they notice they can’t move their head or neck checking blind spots in their car, without getting some of that burning pain that goes down to the shoulder blades.

I had a good friend of mine, Justin, who had this going on for a long time, and he started getting concerned about his neck when he stopped getting relief from cracking his own neck. But he was so busy with work and life that he wasn’t quick to get care early on, and was worried surgery or pills were going to be his only options. The thought of people going in to shave down the disk to perform a microdiscectomy, or putting metal screws and rods to fuse the neck, or even a disc replacement, some serious surgeries, weighed heavy on his mind.

Because this pain was so debilitating

It started affecting his focus, affecting his focus at work, and sleeping at night, and causing some increased irritability he was getting desperate for relief. He found that exercise and working out made him feel better, but that static positions made him feel worse. His treatment plan included getting him into some positions to unload or decompress his head and neck area, help open up some range of motion in his neck with joint mobilizations, improve the postural stability for muscles on the backside with isometric exercises, as well as lengthen tightness on the front side of his chest area with specific stretches. This helped give him relief in static postures like sitting at a desk or driving that calmed down the nerve pain and ultimately took away the toothache pain into his shoulder blades.

What Can I Do About This Pain in My Neck and Shoulders?

I talked to a lot of my patients about this idea or concept. Maybe you’ve seen these YouTube videos where people will sit down with a watermelon, and they’ll just lay rubber band after rubber band on top of this watermelon until, after over 100 rubber bands, the watermelon explodes. Similarly, our discs have a tolerance to tension placed on them, until day after day as we apply tension with poor posture and weak support muscles, we get more and more pressure in our neck muscles and shoulders, and more and more tension, and more and more pain to where we get numbness and weakness down an arm. It’s no longer just focal to that pinched nerve in between the shoulder blades.

Decompress the Disc

What we need to do is start taking tension off the disc that then is pushing into the nerve that’s causing this pain to travel or radiate. And we take off that tension from the disc by helping elongate the head and neck, help decompress or pull that pressure away from that disc, strengthen our postural stabilizers on the backside, and then lengthen our musculature on the front side.

A lot of folks say, “I just need to stretch my neck. It feels so good when I stretch.” That’s because there’s a lot of tension and spasm in the neck and shoulder area that feels like that’s what’s necessary.  However what the neck and shoulder muscles need to ease tension and pain is strengthening and improved posture to help put those muscles on slack.  We put muscles on slack by lengthening the pec major and minor, standing tall to elongate the neck, and strenghten postural stabilizers. Anyway, if you have any further questions or concerns about this kind of diagnosis or disorder, feel free to reach out. We have lots of things we can do to elevate your neck and shoulder pain! To see if we would be a great fit for you check out common conditions we treat for the neck and shoulder.

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Nick Hunter, PT, DPT

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