Neck pain
What’s that terrible pain shooting down my arm(s)?
If you’ve ever experienced a throbbing, severe pain that seems to start near the top of the shoulder and extend all the way down the arm into the hand or fingers, you may be experiencing one of two things, or possibly a combination of the following problems. A myofascial (muscular) referred pain, or nerve root impingement originating in the neck. These two problems present very similarly when presenting yourself to a physician. It is the physician’s capacity and duty to correctly determine, through a thorough examination, and diagnose the problem. Then, a specific and medically necessary treatment protocol can be assigned to you in order for effective and quick prognosis can be attained.
What is a Myofascial Referral Pain?
It is classically defined as hyperirritable loci within taut bands of skeletal muscle that can produce local and referred pain to alternate and patterned regions of the body. There are several of these trigger points (hyperirritable loci) within the body’s musculoskeletal system which have been mapped by several evidence based research programs. These are made available to the general public for educational purposes, and chances are high that you will see these diagrams displayed on the walls of your MD’s, Chiropractor’s, or therapist’s exam rooms. When a Trigger Point is palpated and stimulated, a corresponding pain pattern emerges in a nearby region of the body often, but not always, experienced as radiating pain. For example, if the infraspinatus muscle is hyperirritable, stimulating this muscle will most often result in the patient experience pain sensations down the arm and into the forearm/hand.
What is Cervical Radiculopathy (Nerve Root Impingement)?
Defined as the dysfunction of the nerve roots of the cervical spine, the most commonly affected levels are C7 (60%) and C6 (25%). Symptoms can present as radiating pain, numbness, tingling, muscle weakness, or any combination thereof, down the arms into the hands and fingers either unilaterally or bilaterally. Younger patients which still retain much of their disc fluid, cervical radiculopathy can result from a herniation or an acute injury leading to increased inflammation build up near the foraminal opening of exiting nerves. The herniation, accompanied by inflammation, irritates and compresses the nerve root, sending a variety of signals down the nerve path, interpreted by your brain as pain, numbness, tingling, etc.
Older patients lack the disc fluid, which prevent acute herniations in patients who do not have a history of them, therefore, a majority of older patients present with these symptoms caused by the foraminal narrowing due to formation of osteophytes, degenerative disc disorder, or acute injuries such as whiplash from auto accidents.