Every week, we talk with people on the phone and see wonderful people in our office who are dealing with some type of radiating pain, neck pain, shoulder pain, and elbow pain. Some common complaints consist of aching, sharp, and pinching. Other complaints that we hear are "tingling", "numbness", and "radiating." This is often described by those who have desk jobs are who have had a recent change in work or activity.
All in all - most people aren't sure how this started and they definitely aren't sure if it is something that they should be concerned about. Besides, healthy and fit people don't deal with this sort of thing... right?
What we would like to discuss and answer in this blog is what can be causing this numbness, tingling, and pain you can't explain, or pain that just isn't getting better with treatment.
When someone feels pain or another sensation in a particular area of their body, the first instinct is to think that area is where the actual problem is! This can boggle the mind of the every day person, but it can sometimes get the best of medical providers, trainers, and those who actually study the body.
The reality is that the pain could be coming from one or a combination of the following areas: nerve root entrapment at the spine, entrapment between soft-tissue at the neck, and even nerve entrapment or irritation at the shoulder and scapular region. When radiating pain is felt at the neck and at the elbow level, we can even have two points of actual irritation called "double crush syndrome."
Medicine can get a little complicated at times, which is why it is so important to perform a thorough evaluation that utilizes hands on evaluation, movement, and imaging when necessary. Relying on imaging too heavily can lead to the wrong conclusion about what is causing the pain. Many studies have illustrated this by performing MRI's on healthy people with no pain. Approximately 50% of those people showed some kind of herniation or disc bulge and 10% had findings so severe that if they was pain, then it would warrant surgery. That's a dangerous ultimatum.
The infraspinatus muscle is a rotator cuff muscle on the back of your shoulder, specifically on the back of your shoulder blade. If you arm was by your side and your elbow bent, this muscle would rotator your arm outward. It also helps to properly align your humerus bone with the glenoid fossa of your shoulder blade at resting and while you move. This essentially makes up the shoulder joint.
When the infraspinatus muscle develops trigger points, it can commonly refer pain, tingling, and numbness down the side of your arm and toward your fingers. Those trigger points can also lead to this muscle not doing it's job as good as normally would.
The nerve that connects to the infraspinatus and "gives it the juice" to make it work (innervates) is the suprascapular nerve. This nerve stems from the C6 nerve root which is located at your neck. This C6 nerve supplies sensation all the way down the arm, which can explain the sensations felt down the arm that some people may feel.
This suprascapular nerve, shown above, passes right through this notch in the shoulder blade as it inserts into varying areas of the infraspinatus! This notch is yet another place where it can be irritated.
Without doing a thorough exam to find the source of the pain, one may begin to treat the neck without addressing the tight and restricted infraspinatus muscle and the mechanics. This explains why things like nerve ablations and cervical surgeries often don not completely resolve cervical radiculopathy cases.
Regardless of where the pain is and where the pain is coming from, the good news is that our sports medicine practice in St. Petersburg has non-invasive and natural treatments to alleviate your pain and fix it so that it won't come back!
First, we do a thorough evaluation with both a physical therapist and an osteopathic sports medicine physician where we look at history, goals, movement patterns, physical limitations, and we perform a diagnostic ultrasound scan to look at the exact tissue injury that is causing your pain.
With all of that information and our collaboration, we're able to get an accurate diagnosis and then work together to create a plan to fix your pain, not just put a bandage on it!
Some of those treatment options consist of prolotherapy and Platelet Rich Plasma (PRP) to help your body heal the actual tissue injury, dry needling for trigger point release, and physical therapy to help strengthen, mobilize restrictions, and improve movement dysfunctions!
Don't settle for short term fixes that don't get down to the root cause of the problem. Give us a call so we can find the cause and fix it so it doesn't linger in your life longer than it should!
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