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 cervical part of the spine.

If one of these nerve roots is compressed, due to pressure from a ruptured disc or from pressure from degenerative changes in the bones, damage to nerve function in the extremities results. This damage or disturbance of nerve function is called radiculopathy. Damage to these nerve roots in the cervical area can cause pain and loss of sensation in the upper extremities, depending on where the damaged roots are located.

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. This disk material then 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.


Patients may express that pain or numbness goes away if they put their hands on the top of their heads. This position may relieve pressure on the nerve by increasing the space between the cervical vertebrae.

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). While pain medications may help provide short-term comfort, narcotic pain medication should be avoided for conditions in which long-term pain must be managed.

Physical therapy might include 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 by either removing the offending disk material or enlarging the space where the nerve root exits the vertebrae. This may be called a laminectomy, because the lamina, which is a portion of the bone in the vertebra, is often removed in order to make more room for the exiting nerve root. If the pressure is more severe and disc space narrowed more, an anterior discectomy and fusion can be done.

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