A trapped nerve in the shoulder, often referred to as nerve impingement or cervical radiculopathy, occurs when surrounding tissues place pressure on a nerve. This compression irritates the nerve, disrupting signals sent from the spinal cord to the shoulder, arm, and hand. The pain associated with this condition can range from a dull ache to a sharp, burning sensation that limits movement and function.
What Causes a Trapped Nerve in the Shoulder
Nerves in the shoulder area are primarily part of the brachial plexus, a complex network originating in the lower cervical spine and running through the neck and shoulder into the arm. This anatomical arrangement makes the nerves vulnerable to compression as they pass through narrow spaces created by bone, muscle, and other connective tissues. The impingement often results from mechanical forces that reduce the available space for the nerve.
One common source of pressure is changes in the cervical spine, such as a herniated disc or the development of bone spurs due to degenerative conditions. These structural changes can crowd the nerve root pathways as they exit the spinal column, radiating symptoms down into the shoulder and arm. Acute trauma, such as a fall or sports injury, can also cause immediate swelling or misalignment that directly compresses a nerve.
Poor postural habits, particularly prolonged slouching or forward head posture, contribute to chronic tension in the upper back and neck muscles. This sustained tension can lead to muscle spasms or inflammation, which then squeeze the nerve. Repetitive arm or shoulder movements in certain occupations or activities can also inflame surrounding tendons and muscles, gradually leading to nerve irritation over time.
Immediate Steps for Pain Relief
The immediate focus for managing a trapped nerve is reducing inflammation and minimizing mechanical irritation. The first step is activity modification: resting the shoulder and avoiding specific movements that aggravate the pain, such as reaching overhead or carrying heavy objects. Limiting activities that reproduce the sharp, radiating pain is beneficial for the first few days.
Applying temperature therapy helps manage both acute inflammation and muscle tension. For the first 48 hours, use cold application (like an ice pack) for 15 to 20 minutes to reduce swelling around the nerve. Following the initial acute phase, switch to moist heat for similar 15 to 20-minute periods to relax tight muscles contributing to compression.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can provide symptomatic relief by targeting the inflammation around the irritated nerve. When using these medications, it is important to follow the package instructions and use the lowest effective dose for the shortest duration, typically for no more than a week without medical consultation. Making gentle adjustments to your posture can also offer subtle relief by reducing physical strain on the neck and shoulder.
This involves paying attention to your sleeping position; lying on your back with a supportive pillow or on the unaffected side helps maintain neutral spine alignment. When sitting, especially during prolonged desk work, ensure your chair supports the lower back and your computer screen is positioned at eye level. These small ergonomic adjustments prevent sustained poor positioning that can perpetuate nerve compression.
Professional Medical Interventions
If the pain does not resolve within a week, or if symptoms include progressive numbness, muscle weakness, or loss of control, seek professional medical help. A healthcare provider will begin with diagnostic procedures to pinpoint the source of compression. Imaging tests like magnetic resonance imaging (MRI) or X-rays can reveal structural issues such as disc herniation, bone spurs, or soft tissue inflammation.
In some cases, a nerve conduction study or electromyography (EMG) may be performed to assess nerve and muscle function and confirm the location and severity of the damage. Once a diagnosis is established, physical therapy is often the primary treatment for long-term recovery. A physical therapist designs a specialized program of therapeutic exercises to improve mobility and strengthen supportive muscles in the neck and shoulder girdle.
Physical therapy often incorporates nerve gliding techniques, which are gentle exercises designed to mobilize the compressed nerve and help it slide smoothly through surrounding tissues. This controlled movement reduces irritation and improves nerve signal transmission. Manual therapy, using hands-on techniques to mobilize joints and soft tissues, also helps decrease muscle tension and restore proper movement mechanics.
For persistent pain that does not respond to conservative measures, advanced treatments may be considered. Corticosteroid injections deliver a potent anti-inflammatory medication directly to the area around the compressed nerve root, providing localized relief from swelling and pain. Surgery is generally reserved as a last option for severe cases where symptoms are debilitating, nerve function is deteriorating, or conservative treatments have failed to provide relief after several months.