Suggest treatment for pain in shoulders, upper arm and back

Posted on Tue, 16 Jun 2015 in Bones, Muscles and Joints
Question: I have pain in my shoulder, upper arm and in my back that gets worse with work. At times I get a clicking sound and times when my shoulder acts like it catches on something. I would appreciate your thoughts.
Answered by Dr. Saddiq Ulabidin 2 hours later
Brief Answer:
Line of management for muscular spasms and nerve compressions.

Detailed Answer:

Welcome to Health Care Magic.

Thanks for writing.

I am Dr. Saddiq ul Abidin. I have read your question completely, I understand your concern and will try to help you in best way possible.

Our arm, like all other parts of the body, is being supplied by a set of nerves, which carry sensations as well as messages to carry commands to our muscles to act accordingly.

If you track down the nerves supply of arm, it actually originates from the cervical spine, where any disc prolapse or postural variations may cause a direct compression at a fine network of all the nerves supplying the hand called brachial plexus. In that you would need to have an X-ray cervical spine with AP and lateral view, and a use of neck collar and physiotherapy. Also, if back pain goes to the lower back, it is quite possible that issues with your spine are consistent, through out the length of vertebral column, for which detailed MRI of cervical to lumbar spines may be needed.

The kind of symptoms you shared can also be related to set of muscles which are present around shoulder joint and are called rotator cuff, which give stability to the shoulder joint, but these are vulnerable to mechanical injuries from one side. Since, few of these muscles get their origin from upper back or upper chest, so pain can be referred towards those areas as well.

Although it is very rare, to have a skeletal deformity or mechanical damage to the nerve without having any history of fall, fracture, trauma or intervention done to the arm, as it can often get affected at some sites which are more vulnerable then others, like in your case. And any damage to muscles, supporting the shoulder joint, can make the joint capsule vulnerable to dislocations or damage to ligaments around joint which may present with painful clicks during movements as you explained to have been experiencing.

Don't get confused by the heavy names and nomenclature. Most of these conditions are reversible and curable. In such case you would need to have detailed examination by an orthopediacian after relevant radiographs.

Though mono-neuritis or the involvement of a single nerve is a rare symptoms of some infective or autoimmune disorders. If symptoms increase then you should have the baseline screening of the blood and screening for autoimmune disorders, along with a detailed evaluation with a neurologist to consider more technical studies confirming peripheral nervous system patency with nerve conduction studies or EMGs specially in the areas supplied by axillary nerve as in your case.

At the moment first thing, you need to do is to go to GP of your relevant health care facility, and discuss all the issues with your doctor and let him decide which specialty to be considered first, for a further opinion.

Meanwhile, for supportive measures you can use warm compressions and avoid strenuous activities. Also that if i were your doctor i would have started you on some safer analgesics like acetaminophen along with some muscle relaxants.

I hope this answered your question.If you have more queries I am happy to answer. Otherwise rate before closing the discussion


Dr.Saddiq ul Abidin
M.B.B.S(Licensed Family Physician)
Resident Medicine.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
Follow up: Dr. Saddiq Ulabidin 19 minutes later
Not sure if you are saying if it is a cervical spine issue or rotator cuff. Also not sure what cervical spine is. Neck or back?
Answered by Dr. Saddiq Ulabidin 43 minutes later
Brief Answer:
Clarification of some relevant inquiries!

Detailed Answer:
Hi! I mean to say that, based on the information shared by you, it can be either local or from its origin, and by local i mean rotator cuff (muscles' semicircle) which wraps around shoulder joint and upper arm, and by its origin i mean to say that problem can arise from the very point, where the nerve supply originates from your spinal cord (from vertebral column in your lower neck region aka cervical spine).

Final verdict can be given after careful examination, and by doing various maneuvers, to see the working order of all the muscles present in that area separately and to assess the origin and nature of that clicking sounds which you experience. Also the Radiographs of neck vertebrae ( cervical spine) can be of some clue. If nothing of these is conclusive and the problem persists, you may be asked for an MRI of the affected area to asses the bony framework to every bit of small tissue present in that area.

You can also try sharing a bit more detailed presentation of your symptoms within the maximum possible word limits, so that i can guide you further. I hope That answered your query, if you have any further questions in your mind, feel free to ask. If not, then rate before closing the discussion.


Dr.Saddiq ul Abidin
M.B.B.S(Licensed Family Physician)

Above answer was peer-reviewed by : Dr. Vaishalee Punj
Answered by
Dr. Saddiq Ulabidin

General & Family Physician

Practicing since :2011

Answered : 3030 Questions


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