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Pinched Nerve in Shoulder Blade: A Doctor's Guide to Causes & Relief

Bones, Joints & MusclesBrain & NervesBack & Spine
Pinched Nerve in Shoulder Blade: A Doctor's Guide to Causes & Relief

Key points

  • Radiating Pain: The pain isn't confined to the shoulder blade. It may feel like a sharp, burning, or aching line of pain that travels from the neck, across the shoulder, and down the arm.
  • Numbness or Tingling: A "pins and needles" sensation in the shoulder, arm, or fingers is a classic sign of nerve involvement.
  • Muscle Weakness: You might notice difficulty lifting objects, a weakened grip, or a feeling that your arm is heavy or fatigued.
  • Pain with Neck Movement: Certain neck motions, like tilting your head back or turning it toward the affected side, may intensify the pain in your shoulder and arm.

That sharp, burning, or achy pain nagging you around your shoulder blade can be more than just a nuisance; it can disrupt your work, sleep, and daily activities. While many people call this a "pinched nerve in the shoulder blade," the true source of the problem is often a surprise: it's usually your neck.

This condition, medically known as cervical radiculopathy, occurs when a nerve root in your cervical spine (neck) becomes compressed or irritated, sending pain signals along its path to your shoulder and arm. Understanding the true origin of your pain is the first step toward finding effective and lasting relief.

What Does a Pinched Nerve in the Shoulder Blade Feel Like?

While symptoms can vary, a pinched nerve originating from the neck typically presents with a distinct set of sensations. You may be experiencing cervical radiculopathy if your shoulder blade pain is accompanied by:

  • Radiating Pain: The pain isn't confined to the shoulder blade. It may feel like a sharp, burning, or aching line of pain that travels from the neck, across the shoulder, and down the arm.
  • Numbness or Tingling: A "pins and needles" sensation in the shoulder, arm, or fingers is a classic sign of nerve involvement.
  • Muscle Weakness: You might notice difficulty lifting objects, a weakened grip, or a feeling that your arm is heavy or fatigued.
  • Pain with Neck Movement: Certain neck motions, like tilting your head back or turning it toward the affected side, may intensify the pain in your shoulder and arm.

A tell-tale sign that the issue is in your neck is the abduction relief sign. As noted by the American Academy of Orthopaedic Surgeons (AAOS), some people find that lifting their arm and placing their hand on top of their head actually eases the pain, as this motion can temporarily relieve pressure on the nerve root.

What Causes a Pinched Nerve in the Shoulder Blade? The Root of the Problem

To effectively treat the pain, it's crucial to understand why the nerve is being compressed. The causes can be broadly categorized into issues originating from the spine and those caused by local tissue problems.

Cervical Spine Issues (The Most Common Cause)

Most often, the compression happens where the nerve root exits the spinal column in your neck.

  • Herniated or Bulging Disc: The soft, gel-like discs between your vertebrae act as shock absorbers. An injury or age-related wear can cause a disc to bulge or rupture (herniate), pressing directly on a nearby nerve root.
  • Degenerative Disc Disease & Spondylosis: Over time, our spinal discs lose water content and height. This can cause the vertebrae to move closer together, narrowing the small openings (foramen) where nerves exit. The body may respond by forming bone spurs, which can further crowd the nerve.

!Anatomical illustration showing a herniated disc in the cervical spine pressing on a nerve root. An illustration showing how a herniated disc in the cervical spine (neck) can compress a nerve root, leading to radiating pain. Source: OrthoInfo by AAOS

Local Nerve Entrapment and Myofascial Causes

Sometimes, the nerve is compressed further down the line, away from the spine.

  • Suprascapular Nerve Entrapment: This nerve runs through the shoulder area and can be compressed by repetitive overhead motions (common in athletes) or by cysts. This is a common cause of localized shoulder pain and weakness.
  • Dorsal Scapular Nerve Entrapment: This nerve supplies the rhomboid muscles (between the shoulder blades) and the levator scapulae (which lifts the shoulder blade). When it's entrapped by tight muscles, it can cause a deep, aching pain directly in the shoulder blade area.
  • Myofascial Adhesions: Over time, the fascia (connective tissue) surrounding your muscles can develop adhesions, or "stuck" spots. These can restrict a nerve's ability to glide freely, leading to irritation and pain.

Other Contributing Factors and Risk Factors

Certain lifestyle habits and conditions can increase your risk of developing nerve compression:

  • Poor Posture ("Tech Neck"): As explained by spine surgeon Dr. K. Daniel Riew of NewYork-Presbyterian, constantly looking down at phones and computers forces the muscles in the back of the neck to work overtime. This strain puts excess pressure on your discs and joints, accelerating wear and tear.
  • Repetitive Motions: Jobs or hobbies that involve repetitive arm and shoulder movements can lead to inflammation and swelling that compress nearby nerves.
  • Trauma or Injury: A fall, car accident, or direct blow can cause acute inflammation or structural changes that pinch a nerve.
  • Other Medical Conditions: Arthritis, obesity, and pregnancy can all contribute to tissue swelling or structural changes that increase pressure on nerves.

Diagnosis: How a Doctor Determines the Cause

Because various conditions can cause similar symptoms, getting an accurate diagnosis is key. A doctor will typically use a combination of methods:

  • Physical Examination: Your doctor will assess your neck and shoulder's range of motion, test your muscle strength and reflexes, and may perform specific maneuvers. The Spurling's test, which involves gently compressing the top of your head while you tilt it, can help confirm if the pain originates in the neck.
  • Imaging Tests: An X-ray can show bone spurs or a narrowing of disc space. However, an MRI is often preferred as it provides detailed images of soft tissues, clearly showing a herniated disc or nerve compression.
  • Electrodiagnostic Studies: Tests like electromyography (EMG) and nerve conduction studies measure the electrical activity of your nerves and muscles. They can help pinpoint the exact location of the nerve compression and determine its severity.

Treatment and Relief for a Pinched Nerve in the Shoulder Blade

Most cases of a pinched nerve in the shoulder blade respond well to conservative treatments. The best approach is often a sequenced plan that starts with self-care and progresses as needed.

At-Home Remedies and Self-Care (First Line of Defense)

You can start managing your symptoms immediately with these strategies:

  1. Rest and Modify Activity: The most important first step is to rest and avoid activities that trigger your pain.
  2. Ice and Heat Therapy: Use an ice pack for 15-20 minutes at a time for the first 48 hours to reduce inflammation. After that, applying heat can help relax tight muscles and improve circulation.
  3. Over-the-Counter (OTC) Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve) can help reduce both pain and swelling.
  4. Improve Your Posture: Be mindful of your posture throughout the day. When sitting, try reclining your chair slightly with good lumbar support to take the strain off your neck muscles. Ensure your computer screen is at eye level.
  5. Adjust Your Sleeping Position: According to orthopedic surgeon Dr. John Hinson, sleeping on your back is often the best position. If you are a side sleeper, sleep on the unaffected side and hug a body pillow to support your top arm and prevent your shoulder from rolling forward. A pillow with the right loft (height) is crucial to keep your neck in a neutral position.

Stretches and Exercises for Relief

Gentle movement can help relieve pressure on the nerve and restore mobility. Focus on exercises that decompress the neck and strengthen postural muscles.

*Dr. Rowe demonstrates several exercises to help relieve nerve pain in the shoulder blades. Source: [SpineCare Decompression and Chiropractic Center](https://www.youtube.com/watch?v=VPBY5wQnACw)*
  • Chin Tucks: Sit or stand tall. Gently tuck your chin toward your neck, creating a "double chin." Hold for 5 seconds and repeat 10 times. This helps reverse forward head posture.
  • Shoulder Blade Squeezes: Sit or stand with your arms at your sides. Gently squeeze your shoulder blades together as if you're trying to hold a pencil between them. Hold for 5 seconds and repeat 10-15 times.
  • Head Tilts: Gently tilt your ear toward your shoulder, holding for 15-30 seconds. Repeat on the other side. Do not force the stretch.
  • Doorway Stretch: Stand in a doorway and place your forearms on the frame with your elbows slightly below shoulder height. Step forward gently until you feel a stretch across your chest. This helps open up a slumped posture.

Professional Conservative Treatments

If home care doesn't provide enough relief after a week or two, it's time to see a professional.

  • Physical Therapy: This is a cornerstone of treatment. A physical therapist will guide you through specific exercises to strengthen your neck and upper back, improve flexibility, and reduce nerve pressure.
  • Medications: A doctor may prescribe stronger anti-inflammatory drugs, muscle relaxants, or oral corticosteroids to manage severe pain and inflammation.
  • Corticosteroid Injections: An injection of a powerful anti-inflammatory medication near the affected nerve can provide significant, targeted relief from pain and swelling, allowing you to participate more effectively in physical therapy.

Surgery is rarely needed and is typically only considered if conservative treatments fail to provide relief after several months, or if there is evidence of progressive muscle weakness or spinal cord compression.

When to See a Doctor

While many cases improve with self-care, you should consult a healthcare professional if you experience any of the following:

  • Pain that is severe, persistent for more than a week, or continues to worsen.
  • Significant weakness in your arm or hand, such as dropping objects or being unable to lift your arm.
  • Symptoms that started after a significant injury or trauma.
  • Loss of coordination in your hands.

A proper diagnosis is essential to ensure you are treating the correct underlying issue and to prevent potential long-term complications like chronic pain or permanent nerve damage.

Frequently Asked Questions (FAQ)

How do I get rid of a pinched nerve in my shoulder blade? Relief for a pinched nerve in the shoulder blade typically involves a combination of at-home care and, if needed, professional treatment. Start with rest, avoiding activities that worsen the pain. Apply ice for the first 48 hours to reduce inflammation, then switch to heat to relax muscles. Over-the-counter anti-inflammatory medications (NSAIDs), gentle stretches like chin tucks and shoulder blade squeezes, and improving your posture can provide significant relief. If pain persists, a doctor may recommend physical therapy, prescription medications, or corticosteroid injections.

How can you tell if shoulder pain is from a pinched nerve? Shoulder pain from a pinched nerve often has distinct characteristics. Look for sharp, burning, or aching pain that isn't just in the shoulder but radiates, often starting from the neck and traveling down the arm, sometimes into the hand and fingers. This is frequently accompanied by sensations of numbness, tingling, or "pins and needles." Muscle weakness in the arm or hand, such as difficulty gripping objects, is another key sign. The pain may worsen with specific neck movements, like turning your head.

How long does a pinched nerve in the shoulder last? The duration of a pinched nerve in the shoulder can vary. With rest and conservative at-home care, many people find their symptoms improve within a few days to a few weeks. According to medical sources, over 85% of acute cases of cervical radiculopathy (a pinched nerve in the neck causing shoulder symptoms) resolve without specific treatments within 8-12 weeks. However, if symptoms are severe or persist, it's important to see a doctor, as some cases may require professional treatment to heal properly.

What can be mistaken for a pinched nerve in the shoulder blade? Several conditions can mimic the symptoms of a pinched nerve in the shoulder blade. These include muscle strains (especially of the rotator cuff or upper back muscles), joint dysfunction from arthritis, tendonitis, and thoracic outlet syndrome. A key difference is that these conditions are often localized to the shoulder and worsen with shoulder movement, while a true pinched nerve often originates in the neck and is aggravated by neck movements.

References

Samuel Jones, MD

About the author

Samuel Jones, MD
Orthopedic Surgeon

Samuel Jones, MD, is a board-certified orthopedic surgeon specializing in joint replacement and orthopedic trauma. He is a team physician for a professional sports team and practices at a renowned orthopedic institute in Georgia.