A pinched nerve in the shoulder, medically known as cervical radiculopathy, causes significant pain and limitation, often leading individuals to seek conservative treatment like chiropractic care. This condition arises when a nerve root in the neck becomes compressed or irritated, sending discomfort signals that radiate down into the shoulder, arm, and hand. Understanding the mechanics of this nerve compression and the specific methods a Doctor of Chiropractic (D.C.) uses to address it is important. Before pursuing any treatment, consult a licensed healthcare provider, as this information is not a substitute for professional medical advice.
Understanding the Pinched Nerve in the Shoulder
A “pinched nerve” causing shoulder symptoms is usually cervical radiculopathy, where a spinal nerve root is irritated or compressed as it exits the cervical spine (neck). These nerve roots form the brachial plexus, the network of nerves supplying sensation and motor function to the entire upper extremity. Compression disrupts the normal flow of nerve signals, causing symptoms far from the neck.
Common causes include degenerative changes like bone spurs (osteophytes) or narrowing of the nerve openings (foraminal stenosis). A herniated or bulging disc can also physically press on the nerve root. Symptoms include radiating pain, numbness, tingling, or weakness in the shoulder, arm, or hand, usually affecting only one side.
Chiropractic Assessment and Confirmation
Before any release technique is attempted, a Doctor of Chiropractic performs a thorough examination to confirm cervical radiculopathy. The assessment begins with a detailed patient history focusing on the onset, location, and nature of the radiating symptoms. This is followed by a comprehensive physical examination evaluating the patient’s range of motion, muscle strength, and deep tendon reflexes in the upper extremities.
Chiropractors use specific orthopedic and neurological tests designed to reproduce or exacerbate the patient’s symptoms, confirming nerve root irritation. The Spurling’s maneuver is a common test where the head is gently tilted and rotated toward the affected side while a light compressive force is applied. A positive result, indicated by the reproduction of radiating arm pain, suggests nerve root compression.
Physical findings help the D.C. narrow down the specific nerve root involved, guiding the treatment plan. If severe weakness or lack of improvement is noted, imaging studies like X-rays or Magnetic Resonance Imaging (MRI) may be necessary. These images visualize the exact cause of compression, ensuring appropriate care.
Specific Chiropractic Release Techniques
Chiropractic treatment focuses on restoring proper biomechanics and reducing pressure on the affected nerve root. The primary method is often cervical spinal manipulation, which involves applying a controlled, precise, low-amplitude thrust to a specific joint. This aims to restore normal alignment and motion to the cervical vertebrae, reducing direct pressure on the nerve root.
For patients in acute pain or when high-velocity adjustments are unsuitable, the chiropractor may use spinal mobilization. This gentler, non-thrusting technique uses slow, rhythmic movements of the cervical joints to improve mobility and reduce stiffness. Both techniques improve joint function, reducing mechanical irritation.
Traction or decompression therapy physically creates space within the cervical spine. This is performed manually or using a specialized mechanical device. The distraction force separates the vertebrae, taking pressure off a bulging disc or inflamed nerve root.
Secondary muscle tension often accompanies nerve compression and exacerbates pain. Soft tissue therapy, such as trigger point therapy or therapeutic massage, is used to relax hypertonic muscles in the neck, shoulder, and upper back. Addressing the surrounding musculature helps relieve secondary strain on the irritated nerve.
Post-Adjustment Care and Long-Term Relief Strategies
Achieving long-term relief requires consistent post-adjustment care and lifestyle modifications. The chiropractor typically prescribes a regimen of home exercises designed to stabilize the cervical spine and strengthen supporting musculature. These exercises are tailored to the patient’s condition and stage of recovery.
Specific exercises often include chin tucks, which strengthen the deep neck flexor muscles and promote better alignment by gently retracting the head. Gentle shoulder rolls and range-of-motion exercises are also used to relax the upper trapezius muscles and improve circulation. Patient compliance with these prescribed routines is important for preventing symptom recurrence.
To reduce ongoing strain, ergonomic adjustments are recommended, particularly for individuals who spend long hours sitting. Advice covers proper screen height, chair support, and maintaining a neutral spine position to minimize forward head posture. Modifying sleeping positions, such as using a supportive pillow that keeps the neck aligned, can also reduce prolonged compression on the nerve roots overnight.