Neck, Shoulder or Arm Pain? Could Be Your Brachial Plexus!
Today’s post is by Jonathan Williams, an Exercise and Fitness Specialist from San Jose State University with a B.S. in Kinesiology. He is also the co-founder and president of Silicon Valley Applied Biomechanics (SVAB), a non-profit organization.Many people experience neck, shoulder, and arm pain caused by many different situations. But did you know that these symptoms are often produced by movements we do every day? While traumatic injury is a cause of pain in these common areas, it can also be related to simple everyday movements we do all the time without thinking.
The cervical spine (c1-c7) is where the brachial (related to arm) plexus (bundle or network) originates. At the shoulder and neck area, a common daily movement is lateral bending where the ear and should come together and get farther apart. This movement causes compression or stretching of the nerve bundle that travels through that area. While extreme compression or stretch of these nerves is more often caused by a sports injury or car accident, it can also be caused smaller repetitive movements causing more chronic symptoms.
A common complaint related to brachial plexus irritation is a nagging pain at the shoulder, and a tingling sensation at the pinky or palm. Often these symptoms are reported as being the strongest in the morning or during work situations where posture may be challenged (desk work or holding objects). If the pain lasts more than a few weeks, or even months, it is most likely caused by something you are doing every day. I have had numerous clients who have reported discomfort in the neck and shoulder area which have turned out to have some very unusual causes.
One client was having trouble in the morning with a “frozen” shoulder and was struggling with putting a shirt on in the morning. After asking a number of questions, I asked about her purse and how much was in it. The purse contained a number of items, and weighed more than 10 lbs. This may not sound like a lot, but if you think about carrying 10 pounds on the same shoulder for hours a day, it starts to add up. With the shoulder hiking done on a daily basis, the nerve was constantly being irritated to the point where it was causing serious problems. The suggestion made was to use (at least temporarily) a back pack with two well-cushioned straps, along with a series of back and posture exercises to help rehabilitate the affected area.
Another client was having similar problems caused by something else entirely. This individual was in the last few semesters of his college career, and decided to take up fitness to balance out all the desk work he would be doing. The irritated shoulder, tingling in the wrist / palm indicated that the brachial plexus might be irritated. After checking for postural deviations, I noticed forward-rounded shoulders, which are common amongst people who sit for long periods of time. This can cause compression on the anterior side of the shoulder where the nerve bundle goes through. Again, a series of upper back and postural exercises were prescribed to help counteract the postural distress caused by his career choice.
My last example is someone who owns and operates a day care facility. She was experiencing difficulties when trying to lift anything overhead, and a throbbing sensation in the shoulder during the morning or before bed. It turns out she had been using her dominant arm to hold children for hours at a time without really thinking about it. Here again, a shrugging of the shoulder was causing compression and irritation to the nerve bundle traveling through this area. After going over this, we suggested letting some of the helpers hold the kids more often, at least for a short while, to help rehabilitate the muscle group. This combined with a series of exercises have caused the symptoms to subside.
What should I do if I am experiencing similar problems?
The first thing you will want to do is identify what may be causing the problem. While you may need to see a specialist for symptoms caused by traumatic injuries, you can start to narrow it down by thinking about what you do often with your neck and shoulders. Do you have a desk job, or sit for long durations? How is your posture during this time? Do you carry a purse or briefcase on one side? Do you hold objects on one side for long durations? We are looking for things that require your shoulder to elevate and in turn compress the nerve plexus.
If you do find that you may be having these issues, give your body a break from what may be causing the irritation. This may not always be possible with work situations, but you may be able to modify your work station, how you carry your bag, or how you hold objects to help reduce the stimulus. Icing and anti-inflammatories may be temporarily useful, but would not be considered a solution to the problem itself.
After a period of rest and recovery, you can begin to use rehabilitative exercises to strengthen the affected area. Upper back and postural exercises are often prescribed by physical therapists to combat brachial plexus issues, but why wait until it gets that bad? Even if your symptoms are not that bad yet, you can always think about PRE-habilitating yourself.
References
Frederic H. Martini, Michael J. Timmons, Robert B. Tallitsch.
Human Anatomy-5th Ed.
Prentice, William E.
Principles of Athletic Training: a Competency-Based Approach – 14th Ed.
Chad Starkey, Sara D. Brown, Jeff Ryan.
Examination of Orthopedic and Athletic Injuries – 3rd Ed.