Neck/Shoulder/Arm Pain

[MarkBurnham]

Hi

I have recently been having problems with my neck/shoulder which is also causing problems with my arm and hand.

It started when I participated in my first gym session of the new year after a 2 week break. Stupidly I failed to warm up properly and went straight onto to the assisted pull up machine. After the first set I felt a "niggly" pain in at the base of my neck/shoulder. I did the sensible thing and stopped any weightlifting exercises and left the gym.

I didnt experience any more pain through the day it was more a mild discomfort but as the night wore on it became unbearable. The pain had spread all the way down my right arm into my hand and I had a loss of feeling in my index finger on the right hand and on part of the back of the hand. I could only get comfortable lying flat on my back looking at the ceiling with my arm in a variety of positions.

For the next 7-8 days I was constantly popping ibuprofen tablets to take the pain away and resting (this was my doctors advice). Its now been 3 weeks and the pain has died down but not totally gone away, I no longer require pain killers to be comfortable. But I still have a numb fingertip and hand and I can not contract my tricep fully on this arm and my right pec is not contracting as much as my left. I also get shot of pins and needles down the arm if I sit a certain way.

I've done plenty of research on line and it sounds as though I have pinched a nerve. Does this sound correct?

Has anyone on here experienced similar problems before? How long did it take for full strength to return?

Thanks

Mark


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[Dr Damien]

Dear Mark

From what you have written, I wouldnt say you have pinched a nerve, I think you may have a traction injury to your lower brachial plexus...

i say this because the area affected seems wide..the distribution is mainly in the C7/T1, the area where u feel parashthesia and pain down the upperlimb suggests this...also the triceps and pecs share that root supply (C7/T1) but they are supplied by different nerves, this is why a single pinched nerve is unlikely...the problem is coming from where they both share this supply...
My mind would be thinking the lower part of your neck...here you have the lower brachial plexus...a traction pull could tear it causing the type of pain and symptoms you describing...similar to erbs palsy in children...

other causes could be a prolapsed disc from between C7/T1(or a facet joint problem...unlikely because this would mean you have a degenerated spine, something not common with people your age)...it is unsusual to have multiple discs out except in the elderly or with serious trauma, also its usually the mid to upper lower discs that easily pop out (c4-c6)...however disc protrusion are common in your age group so this is another possibility...in addition, you say sitting affects it...sounds discy...

the fact the ibruprofen is helping indicates that the area is inflammed and that is getting better...

Can you describe the mechanism of your injury in detail...

In the interim you need a good assessment of your neck...this is where the problem is

cheers

[MarkBurnham]

Thanks for the reply

In terms of the mechanism of the injury, bending my neck forward so that my chin is touching my chest is painful. It feels quite tight as if a muscle is pulled/strained and doing this is stretching it. I experience a similar sensation if I arch my neck backwards to look up but not to the same extent. I do not experience any form of discomfort if I turn my head to either side.

As I have said I have no real strength in my arm, the numbness is not extreme, mainly the tip of my index finger and a small patch on the back of the hand.

Thanks

Mark

[pudding_bowl]

Sounds like you should try some retraction exercises first and see if they would be helpful... google it. Pretty classic mckenzie stuff and quite a subtle exercise very unlikely to aggrivate your condition. Definately a good idea to get a physio to have a look at you though because it's highly likely you may benefit from manual therapy in the thoracic spine. There are a number of possible pathologies that could be causing your pain and a thorough assessment would allow some more clarity.

What you have given us is information about your current situation, not your mechinism of injury. What we mean by mechanism of injury is what happened? did you do the pull ups with the bar behind or infront of the head etc. Just a bit more detail.

cheers,
Pud

[MarkBurnham]

Thanks again, I'll take a look at the advice you have given me and try the stretches, also looking into visiting a physio this week

With regards to the injury. I was using the assisted pull up machine and set the weight to half my body weight (80kg) to try and ease into them. I was using a wide grip and the bar was in front of my head. It is the 1st time Ive really tried to do this exercise.

Thanks

Mark

[Vanc_WA_PT]

I'll play the nerve compression card just to be different and say that as you did your pull up, you tilted your head back ever so slightly at the top of the exercise; the neck extension plus the stabilizing contraction of the levator scap muscle pinched a couple nerve roots on the affected side sending radiating sxs into your arm/hand and creating spasms in the suboccipital muscles (or maybe cervical facet restriction) which will feel tight when the neck is bent forward; treatment options i'd look into would be soft tissue work to loosen the neck and upper traps, cervical distraction to stretch cervical muscles and possibly decompress nerve roots, rest, ice and ibuprophen to calm nerve roots; upon return to gym be sure to keep neck in a neutral position during all exercises. Good luck.