Recently in the clinic I seem to have had many patients coming in complaining of having a trapped nerve in neck pain. The first thing everyone says is: “I think I have a pinched nerve”. They say this whilst trying to look at me with their head slightly bent to one side and their neck looking like a Frankenstein stuck in a bolt and nut through it so stiff.
This is a classic story many chiropractors will tell you that they have seen before. Many patients come through their doors having woken-up with a stiff neck which progressively got a lot worse through the day. The inside of the right or left shoulder-blade, shoulder or arm might be killing them as well. So I thought I would tell you what I have seen as the two most common causes, symptoms of a pinched nerve, and 12 tips for what you can do yourself to get some pain relief today.
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You think you have a nerve that is being trapped which is causing all that pain into your neck maybe referring into a shoulder or arm.
By definition a symptom is usually what you can feel or see. A symptom is usually how you would explain what your feeling to your chiropractor or doctor.
What are some symptoms of a nerve being compressed in your neck?
Remember those patients with the neck ache I mentioned earlier, the ones who would come into a Chiropractic clinic with their neck in a torticollis position? These are some of the common answers I would hear from them as they try to describe their symptoms:
- I woke up and getting out of bed, or in the shower, I then felt my neck twinge and within a few hours my neck was really sore and now my neck is stuck.
- The pain is mainly in my shoulder, on top of my shoulder, down the inside of my shoulder-blade and the back of my arm with pins and needles down in my finger tips.
- My arm pain feels worse than my neck.
- If I raise my arm above my head it relieves the shoulder pain.
- Painkillers and anti-inflammatories are not helping at all to relieve my neck or arm pain.
- The pain is a deep, throbbing, ache in my arm.
- I have never had a problem like this before with a neck pain.
- The pain is worst in the early morning hours and wakes me up from sleep.
- I cannot find a comfortable position to get neck pain relief.
- Trying to drive the car was really sore and made the pain worse.
Sound familiar? These are just some of the ways patients might explain the symptoms of a nerve entrapment.
Want to know “what does nerve pain actually feel like?” it is best described as a deep, throbbing, pain in the bone, worst pain you have ever felt pain.
This is because with a true nerve irritation you will be experiencing what is medically termed, neurogenic pain.
Neurogenic pain is DIFFERENT from inflammatory pain.
Inflammatory pain is like when you have a back pain from pulled a muscle.
I did promise I would tell you what are the two most common causes for why I see people wake-up in the morning with a wry neck or trap a nerve in the back of their neck or shoulder blade.
Before I tell you I would like you to first have the knowledge of the anatomy of a normal neck. I thought the following video shows quite nicely the basic human biology of the cervical spine. After watching the video you should be able to visualise key concepts like: what is a cervical disc, what is a cervical spinal nerve root and the what are the cervical facet joints.
Cause #1: A Problem with a Cervical Disc
A disc in your cervical spine could be a problem if you develop a prolapsed or herniated disc. Only an already degenerating unhealthy disc will cause a sudden, non-traumatic neck pain. Why this is so important to know because if you end up going for an MRI scan of your neck then it is common radiological finding to report a bulging, degenerating, dehydrated disc. Even healthy, pain-free people can have poor looking discs on a MRI scan.
What can happen to a cervical disc is micro-trauma tears to the outside of area of the disc, called the annulus fibrosis. These tears, delamination, could have occurred for no apparent reason over several months or years until one day you finally end up with a painful pinched nerve in your neck. The middle of the disc, called the nucleus pulposus, can then bulge the disc outwards or cause a herniation of its material even into the spinal cord space.
Signs of degeneration of the spinal joints (facet, uncinate) are another common finding. Degenerative changes in the joints of the neck are usually called spondylosis (a.k.a osteoarthritis) on a neck x-ray report. Where the disc is degenerating the joints are degenerating and visa versa. See how disc degeneration progresses occurs below.
Cause #2 can be a synovial meniscoid entrapment
You are probably asking “what the hell is a synovial meniscoid?” A synovial meniscoid is a normal structure found in all of the spinal joints of your neck. It is thought a synovial meniscoid can get trapped between the two surfaces of the joints of the neck. In the literature it is not common, but I definitely think it can happen.
In this case a person may present with a more local base of neck pain without major signs of a spinal nerve root compression coming from a disc injury. A pinched synovial meniscoid pain is typically one-sided and over the cervico-thoracic (CT) junction area of the spine. This is where your neck meets your upper back and is where the big bone (vertebrae prominens) at the back of your neck is found.
12 Self-Treatment Tips
If after an examination your chiropractor or doctor confirms that you do have what I call a true trapped nerve in your neck or shoulder then they will advise you further what they could do professionally to help you get some relief from the pain.
I believe many people may think they have this type of genuine nerve pain. However, what I mean by a true trapped nerve is a situation where the spinal nerve root coming of your spinal cord is either being irritated by a cervical disc lesion (like a herniation) or overstretched like in a stinger injury. This can occur with or without pain going down the inside of the shoulder blade or outer arm and forearm, and especially at the elbow. Medically this could be termed a cervical radiculopathy.
Here is a list of 12 more treatment tips:
- Don’t Avoid Seeing a Chiropractor/Doctor
This is rule number one because even though you can try do some home treatment now, if you do have a more serious cause of nerve entrapment in your neck that this can cause you to lose function in that nerve. This is not to be alarmist, but pain is just a warning sign. There are worse things that can happen from having a trapped nerve. You may not realise linked problems like loss of muscle strength, bowel bladder changes from a severe disc herniation. There are other serious causes like an infection or tumors. Using a healthcare professional first to give you a diagnosis of your neck pain helps you then decide what to do next.
- Try the Bakody Sign Position
The bakody sign is used to both diagnose and treat. To get pain relief from the pressure of a trapped nerve you would raise the affected arm, palm side down on top or behind your head. See the bakody’s sign position.
- Avoid Prolonged Sitting
Sitting for too long will cause your head to slowly shift forward on your neck bone. This bad posture will place more stress on the spinal joints and discs in your neck. Not good when they might be inflamed or the nerve irritated. This also leads to a condtion called anterior head carriage, forward drawn posture or upper crossed syndrome.
- Use a Cervical Pillow
I believe good pillow support will lower the stress placed on your neck and upper back. Supporting the joints of your neck will help lower the risk of further nerve irritation. I am a fan of the memory foam pillows. Memory foam pillows come in many shapes and sizes. There are lots of different brands out there for example like Tempur pedic. However, at the end of the day, any good pillow support from any type of pillow is definitely another important treatment exercise to help you control the neck pain levels.
- Move Your Neck In Pain Free Directions
Immobilizing the neck completely with a neck collar can cause more neck ache and pains. Moving your neck gently in pain-free directions will then allow the other normal joints and discs in your neck to stay healthy. It is a fine balance between the amount of rest and movement.
- Neck Exercises
The movement relationship from your jaw joint, neck, upper back, shoulder blade and all the way down the arm play an important part in fixing the problem. Have a look at the beginners neck pain exercises using two simple neck dynamic neuromuscular stabilization moves, these neck isometrics or look at releasing your trapezius muscle.
- Neurogenic Pain Medication vs Inflammatory Pain Medication
At the end of the day the neck or shoulder and arm pain is what you are most concerned about. So how can you control the pain levels with medication? Chronic pain can occur from a severe acute pain episode therefore using appropriate trapped nerve medication can lower your risk of developing chronic neck pain. There are many different kinds of pain medication for trapped nerves, muscle spasms & inflamed joints. So speak to your doctor if your current pain medication is not helping. Neurogenic pain is specific to nerves vs inflammatory pain which is general.
- Using Cervical Traction Home Kits
Caution must be advised if you are seeking to perform cervical traction at home on your neck. Traction is thought to be best if cervical traction is intermittent. Large amounts of force are not needed with traction of the neck. Your local chiropractor or orthopaedic/neurosurgeon could advise you on their personal feelings about using home cervical traction devices. Sometimes it is best left to your healthcare provider to perform the cervical traction for the pain in the neck.
- Keep Hydrated
Being in constant pain can make you forget to drink water. If you are taking lots of trapped nerve pain killers and not eating or sleeping properly then hydration levels can become an issue. Excessive pain medication can stress your liver and kidneys. That is why hospitals are likely to put new admission patients on an intravenous (IV) saline drip. Remember to try drink some glasses of water during the day to help create a better natural healing environment in your body.
- Eat an Anti-Inflammatory Diet
Inflammation to some degree will be affecting the nerve entrapment pain in the neck.
Decidingprescribing what you eat can have an effect on your pain levels and how fast your body can heal itself. Eating anti-inflammatory foods like the ones recommended in the Deflame Diet can be such a simple way to enhance your recovery.
- Hot Wraps and Cold Packs
The general rule is heat is a natural muscle relaxant, cold is a natural anti-inflammatory and pain-killer. Microwaveable wheat bags, warm moist towels and hot water bottles are easy sources of heat therapy. The blue gel, moldable freezer ice packs are my favourite source of cold therapy. For ice keep it wrapped up in a dish cloth so you don’t freezer burn yourself and leave on the neck for 10-20 minutes with 1-2 hour breaks in between. For a disc pain try ice and for a meniscoid entrapment try heat.
- Try Magnesium Supplements
[NEW] Read more about how low levels or magnesium deficiency is linked to a depressed nervous system and inflammation. After my own self-experiment and seeing what happens in patients with neck pain this is such a simple treatment tool not to be missed. Read more about magnesium supplements for pain.
More good news is there are some neck exercises you can try perform by yourself whilst getting your appropriate professional treatment. These exercises can be found in a self-help book by Robin McKenzie called “Treat Your Own Neck”. In the book, which is available to buy through Amazon, Robin goes through his regular rehabilitation exercise movements to help treat excess pressure on a disc in your neck.
The Bottom Line
This self-help list for a pinched nerve is not everything, but only a guide. The above list of do it yourself treatments hopefully, should give you some good ideas as to what you can do to help trapped nerve in the neck episode. I hope you get better soon.