Radiating Shoulder Pain

Has your shoulder pain begun travelling below your elbow or into your forearm or hand? Does the pain shoot, burn, or travel down your arm? Are you experiencing numbness, tingling, or weakness in your shoulder, arm, or hand? Some episodes begin suddenly after lifting, reaching, or an awkward movement. Others develop gradually without any obvious injury.

The fact that your pain travels beyond your shoulder is an important clue. Unlike localized shoulder pain, radiating pain often suggests irritation involving one or more of the nerves supplying the shoulder and arm. Although these symptoms can be alarming, they do not necessarily mean you have suffered nerve damage or that your only option is surgery.

If your pain stays mainly around your shoulder without travelling below your elbow, please click here to learn about localized shoulder pain.

Many patients assume radiating shoulder pain automatically means the pain is referring down the arm as a result of a torn rotator cuff. In reality, this is more suggestive of nerve compression involving the neck or shoulder than an isolated rotator cuff injury.

In my 30 years of clinical practice, I have found that radiating shoulder pain commonly results from the coupling pattern between the muscles of the neck, upper back, and shoulder. When shoulder movement becomes painful, these muscles work together in a modified pattern to compensate for the loss of normal shoulder movement. As lifting the arm becomes more difficult, the stabilizing neck and upper back muscles contract to elevate the shoulder and help initiate arm movement.

Over time, this altered movement pattern often leads to secondary muscle splinting, loss of normal shoulder movement, scar tissue, and adhesions, all of which further increase pain and limit mobility. Compression or irritation involving the cervical spine or surrounding nerves can then produce pain, numbness, tingling, or weakness that travels well beyond the shoulder into the arm and hand.

Separating out the individual components involved and establishing exactly what is causing what is the key to your prognosis and response to conservative, non-operative care.

Episodes of uncomplicated shoulder pain that resolve within a few days are usually suggestive of a simple muscle strain without significant underlying structural or biomechanical involvement.

With radiating shoulder pain that travels below your elbow, or where numbness and tingling persist beyond a few days, I recommend you do not continue trying home remedies before having it evaluated.

Many patients begin stretching, strengthening, or searching online for rotator cuff exercises. Unfortunately, these generic recommendations often only serve to further irritate already inflamed tissues and do little to address the actual underlying cause of the problem.

Identifying all components of the underlying injury and reducing irritation around the affected nerve is the first step toward relieving your symptoms.

Most times, yes. The good news is that most cases of radiating shoulder pain respond very well to conservative care once the actual source and all associated components have been accurately diagnosed. Over the past 30 years, I have had the privilege of helping thousands of patients with radiating shoulder pain, with most returning to their normal activities without surgery.

If your shoulder pain is travelling below your elbow, into your forearm or hand, or you are experiencing persistent numbness, tingling, or weakness, I recommend you do not continue to put off getting it evaluated.

Different underlying conditions often produce remarkably similar symptoms, but they do not all require the same treatment. An evaluation is designed to determine exactly what is causing your pain so the right treatment can be recommended from the start.

Important: If your left shoulder pain is associated with chest pain, pressure, shortness of breath, sweating, nausea, dizziness, or pain travelling into your jaw, seek immediate medical attention. These symptoms may represent a heart attack and should not be assumed to be coming from your shoulder.