Member Case Study: Pinched Nerve

author : AMSSM

comments : 1

I have a pinched nerve in my neck at C6 which is causing a burning pain in the upper shoulder and down the triceps of my right arm. I worry about training and doing long-term nerve damage.

Member Question from amoshill

I have a pinched nerve in my neck at C6 which is causing a burning pain in the upper shoulder and down the triceps of my right arm.  It is also causing tingling and numbness in my right index finger and thumb.  The burning pain is exacerbated by sitting and typing.  Pain does not seem to be made worse by physical activity for the most part. Symptom onset was in January when I was under a lot of stress and had terrible muscle knots in my shoulders and back.  Most of them were worked out by a massage therapist but this lingers on.  I worry about training and doing long-term nerve damage.  I am not able to see an orthopedist until the first week of May.  Any suggestions?

Answer from Rebecca Carl, MD
Member AMSSM

The vertebral column is made up of twenty five bones stacked up on each other.  Each back bone, or vertebra, has a hole in the center; the spinal cord sits in the tunnel created by the holes in the column of stacked vertebrae.  The bones of the spine are labeled by location; cervical vertebrae (labeled with a ‘C’) are in the neck, thoracic (‘T’) vertebrae are in the middle, lumbar (‘L’) vertebrae make up the lower spine, and the bottom-most vertebrae is called the sacrum.   

Between each pair of vertebral bones sits a cushion called an intervertebral disc.  People often compare these discs to jelly donuts because they have a tough outer coating and a gelatinous material inside. The spinal cord or one of its large branches can get irritated when a disc bulges outward or its jelly leaks out.  Narrowing of the opening in the spine bones due to atypical structure of the neck bones, injury, or arthritis can cause similar symptoms.  

Your description of symptoms is strongly suggestive of irritation of a nerve root, one of the spinal cord’s large branches.  Generally, flexion of the spine (bending forward) makes this type of pain worse.  While you are waiting to see an orthopaedic physician, the best course of action is to modify your training to avoid painful activities and positions.  You could also consider taking anti-inflammatory medication, such as ibuprofen or naproxen, on a schedule for 7-10 days to decrease irritation of the nerve root (as long as you have no medical conditions that make taking these medications inadvisable).  Your primary care physician may be comfortable seeing you initially and prescribing a course of physical therapy.  Permanent nerve damage is unlikely with relatively prompt treatment; however, if you have a dramatic increase in the intensity of pain or you develop weakness in the muscles of your hand and arm, you should be seen by a physician right away.   

Rebecca Carl, MD 
Children's Memorial Hospital, Chicago

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date: May 21, 2010