Nerve pain shoulder numbness finger
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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There are seven vertebrae (bones) in the neck.
These vertebrae form tunnel around the spinal cord. A soft disc separates each vertebra, providing cushioning. At the level of each vertebra, a nerve root exits through an opening and joins with other nerve roots to form peripheral nerves that travel down the neck, shoulders, and arms.
If these nerve roots are compressed, due to pressure from a ruptured disc or from pressure from degenerative changes in the vertebrae, damage to nerve function in the arms or legs results. This damage or disturbance of nerve function is called radiculopathy.
Damage can occur as a result of pressure from material from a ruptured disc, arthritis or other injuries that put pressure on the nerve roots. In older people, normal degenerative changes in the discs as well as arthritis in the facet joints of the vertebrae can cause pressure on nerve roots.
In younger people, cervical radiculopathy tends to be the result of a ruptured disk. The disk material compresses the nerve root, causing pain.
The primary symptom of cervical radiculopathy is pain radiating into the arm, neck, chest, and/or shoulders. Numbness or tingling in fingers or hands may also be present, as well as muscle weakness. Other symptoms may include lack of coordination, particularly in the hands.
Depending on what level the radiculopathy is occurring (meaning at which cervical vertebra), the pain and weakness will be experienced in different areas.
• Damage to the nerve root between the C4 and C5 vertebrae (C5 root) will result in pain at the base of the neck that radiates to the shoulder and upper arm. Weakness will be felt in the biceps, with some numbness over the shoulder.
• Damage to the nerve root at the C5 – C6 level (C6 root) will result in pain that radiates from the neck to shoulder and shoulder blade, down the outside of the arm. Weakness will be felt in the biceps, with numbness along the thumb and index finger.
• Damage to the nerve root at C6 – 7 (C7 root) will result in pain from the neck and shoulder down the outside (lateral) surface of the arm, to the middle finger. Weakness will be felt in the triceps, with decreased sensation along the back of the hand and middle finger.
Treatment focuses on both reducing compression on the nerve roots and relieving symptoms.
Cervical radiculopathy may be treated with a combination of steroids or non-steroidal pain medication (NSAIDs) and physical therapy. Steroids may be prescribed either orally or injected into the epidural space( the space that surrounds the spinal cord).
Physical therapy includes gentle cervical traction and mobilization, exercises, and other modalities to reduce pain.
If significant compression on the nerve exists to the extent that motor weakness results, surgery may be necessary to relieve the pressure.
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