Pain in shoulder cervical spine
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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The cervical spine is made up of seven vertebrae. The first cervical vertebra, C-1, interacts with the occiput of the skull above and with the second cervical vertebra, C-2, below.
The C1-skull joint primarily allows flexion and extension, while the C1-C2 articulation provides rotation. Vertebrae C-3 through C-7 allow for flexion, extension, lateral bending, and rotation. Flexion centers on C-5 and C-6 and extension on C-6 and C-7, which is why degenerative changes occur more commonly at these levels.
Intervertebral disks are found from C2-3 and below. Eight pairs of cervical spinal nerves exit through the intervertebral foramina.
The posterior part of the cervical vertebrae contain the facet joints, while off the lateral margins of the vertebrae are the uncovertebral joints. Both joints can degenerate and adversely affect the surrounding anatomic structures, including the spinal cord and exiting spinal nerves.
The muscles of the neck are divided into four major compartments: anterior (flexion), posterior (extension), and the lateral groups (lateral bending).
Muscle strains usually get better within a few days to a couple of weeks, ligament sprains may take up to two to three months, and disk injuries or herniations with nerve injury can take three to six months for recovery.
Localized pain generally points to muscle strains, ligament sprains, and facet or disk degeneratiion. Disorders in these areas also radiate pain to the shoulder blade or upper trapezius muscle as well.
Upper cervical nerve issues refer pain to the head (C-1, C-2), the neck (C-3), and the upper trapezius region (C-4). The C-5 nerve transmits pain to the shoulder and lateral arm, and occasionally the radial forearm. The C-6 nerve pattern is similar butincludes the radial forearm and thumb. The C-7 nerve refers pain to the posterior arm, dorsal forearm, and the index and middle fingers. The C-8 nerve radiates pain to the medial arm, ulnar forearm, and the ring and little fingers.
The lower cervical nerve roots, disks, spinal longitudinal ligaments, and facet joints refer pain to the shoulder blade.
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