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Pinched Nerve in the Shoulder: Symptoms, Causes and How to Get Relief

A «pinched nerve in the shoulder» usually means a nerve root irritated in the neck, where the nerves for the shoulder and arm leave the spine. The result is sharp, burning or electric pain around the shoulder blade, the top of the shoulder or down the arm, often with tingling or numbness. Less often, a nerve is compressed around the shoulder itself. Most cases improve within weeks to a few months with the right activity, physiotherapy and time.

Topic
Physical therapy
Updated
Reading time
6 minutes
Reviewed by
Dr. Itziar Gotxi Erezuma · Medical doctor (ENT) · Bizkaia Medical Association no. 484809757

Where the nerve is actually pinched

Doctors call a pinched nerve root in the neck cervical radiculopathy. The nerve can be irritated by a bulging or herniated disc, by bony spurs and thickened joints from cervical spondylosis, or by narrowing of the opening where the nerve exits the spine. Inflammation around the nerve is often as important as pressure itself, which is why symptoms can improve even when a scan still shows the disc. The same process in the lower back causes sciatica; see pinched nerve in the lower back.

Less commonly, nerves are compressed around the shoulder: the suprascapular nerve near the top of the shoulder blade, or the nerves and blood vessels between the collarbone and first rib (thoracic outlet syndrome). These cause shoulder blade ache, weakness when lifting or rotating the arm, or arm tingling with overhead activity.

Typical symptoms

  • Sharp, burning or shooting pain in the shoulder, the shoulder blade or between the shoulder blades.
  • Pain spreading down the arm, sometimes to particular fingers.
  • Pins and needles or numbness in the arm or hand.
  • Weakness in lifting the arm, bending the elbow or gripping.
  • Neck stiffness, with pain worse when looking up, turning the head or tilting it towards the painful side.
  • Relief when resting the hand on top of the head, which reduces tension on the nerve.

Pain felt between the shoulder blades is a frequent early sign of a neck nerve problem; see pain between the shoulder blades and shoulder blade pain.

Pinched nerve or shoulder joint problem?

  • Points to the neck: pain changes with neck movements, spreads below the elbow, comes with tingling or numbness, and the shoulder moves fully.
  • Points to the shoulder joint: pain on lifting the arm or reaching behind the back, a painful arc, night pain lying on the shoulder, and no tingling.
  • Frozen shoulder: gradual, marked loss of movement in all directions; see frozen shoulder.
  • Rotator cuff problems: pain and weakness with lifting or rotating the arm; see rotator cuff exercises.

Neck and shoulder problems can coexist, so a clinician usually examines both.

Causes and risk factors

  • Disc herniation: more common between 30 and 50; may follow lifting or a sudden movement, or appear without a clear cause.
  • Cervical spondylosis: age-related changes in discs and joints that narrow the space for the nerve, more common after 50.
  • Sustained postures: long periods looking down at screens or sleeping in awkward positions do not damage nerves on their own but can aggravate symptoms.
  • Repetitive overhead work or sports: relevant for nerves compressed around the shoulder.
  • Injury: falls, contact sports or whiplash.

How it is diagnosed

A physiotherapist or doctor asks about the pattern of pain and tests neck movements, shoulder movements, strength, reflexes and sensation in the arms. Gentle provocation tests reproduce or ease the arm symptoms. Scans are not needed at first in most people. An MRI is considered when symptoms are severe, keep getting worse, last beyond six to twelve weeks despite treatment, or when warning signs appear. Nerve conduction studies can help when the source is unclear.

Treatment that helps

  • Stay active within comfort: complete rest and neck collars are not recommended for more than a few days.
  • Pain relief: paracetamol (acetaminophen) or anti-inflammatory medicines if suitable; your doctor may suggest other options for nerve pain.
  • Physiotherapy: neck and shoulder blade exercises, manual therapy and advice on posture and activity. Exercise for neck disorders has good supporting evidence.
  • Heat or ice: whichever eases muscle spasm.
  • Sleep position: a supportive pillow that keeps the neck level; see neck pain from sleeping.
  • Injections or surgery: for a minority with severe pain that does not respond, or with progressive weakness.

Gentle exercises to start with

  • Chin tucks: sitting tall, glide the chin straight back as if making a double chin, hold for 5 seconds, repeat 10 times.
  • Shoulder blade squeezes: draw the shoulder blades gently back and down, hold for 5 seconds, repeat 10 times.
  • Neck rotation within comfort: turn slowly to each side only as far as is pain-free, 5 to 10 times.
  • Hand-on-head rest: resting the hand of the painful side on top of the head for a minute can ease arm pain.
  • Nerve glides: only as taught by a physiotherapist, gently and without provoking symptoms.

Stop any exercise that makes pain spread further down the arm or increases numbness. Improving a forward head posture can also help; see forward head posture.

When to seek urgent help

  • Weakness in the arm or hand that is getting worse.
  • Symptoms in both arms, or in the legs.
  • Clumsy hands, difficulty with buttons or handwriting, or unsteady walking.
  • Loss of bladder or bowel control.
  • Pain after a significant fall or accident.
  • Fever, unexplained weight loss, a history of cancer, or constant pain at night that does not ease with any position.

Key points to remember

  • Most «pinched nerves in the shoulder» start in the neck.
  • Pain that changes with neck movement and spreads down the arm points to a nerve root.
  • Staying active, pain relief and physiotherapy help most people within weeks.
  • Progressive weakness or symptoms in both arms need urgent assessment.

Questions about a pinched nerve in the shoulder

These answers are general information and do not replace an examination or individual medical advice.

How long does a pinched nerve in the shoulder take to heal?

Many people improve within 6 to 12 weeks. Numbness and weakness can take longer to recover than pain.

Can a pinched nerve in the neck cause shoulder blade pain?

Yes. Pain at or between the shoulder blades is a common symptom of an irritated nerve root in the lower neck.

Should I rest or move with a pinched nerve?

Keep moving gently within comfort. Long rest and collars tend to delay recovery.

Do I need an MRI for a pinched nerve?

Usually not at first. An MRI is considered for severe or worsening symptoms, warning signs, or no improvement after several weeks.

What is the best sleeping position for a pinched nerve?

On your back or on the non-painful side, with a pillow that keeps the neck level. Some people find resting the arm on a pillow helpful.

Can a physiotherapist help with a pinched nerve?

Yes. Physiotherapy with exercises and manual therapy is a first-line treatment and helps most people.

Sources

  1. Blanpied PR, et al. Neck pain: revision 2017. Clinical practice guidelines linked to the International Classification of Functioning, Disability and Health. J Orthop Sports Phys Ther. 2017
  2. Gross A, et al. Exercises for mechanical neck disorders. Cochrane Database Syst Rev. 2015
  3. NHS · Neck pain
  4. NHS · Shoulder pain
  5. NHS · Cervical spondylosis
  6. NHS · Thoracic outlet syndrome

This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.