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Dr. Andrew Rynne

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What causes neck pain radiating to left shoulder?

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Dr. Karl Logan

Orthopaedic Surgeon

Practicing since :1999

Answered : 705 Questions

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Posted on Tue, 12 Aug 2014 in Elderly Problems
Question: I have neck pain that radiates down to my left shoulder, to elbow and also on the left side down to my waist and down to mm left knrr.
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Answered by Dr. Karl Logan 1 hour later
Brief Answer:
Cervical disc prolapse / radiculopathy

Detailed Answer:
Hi,

Thanks for your question. Neck pain that radiates into your arm is consistent with a cervical disc prolapse and compression of one of the nerve roots to your left arm. The commonest would be the C5/6 level with C6 nerve root compression.

The pain extending to your waist and into your knee however would not be compatible with this and may have to be explained separately.

Tests that can be done include:

X-rays
X-rays can show the alignment of bones along the neck. They can also show any narrowing of the foramen and disks.

Computed tomography (CT)
CT scans show the bones of the neck in finer detail. Bone spurs can be seen with CT, especially spurs near the foramen.

Magnetic resonance images (MRI)
An MRI of the neck can show if nerve compression is caused by soft tissue, such as a bulging disk and herniations. MRI can also show the appearance of the spinal cord and nerve roots.

Electromyelography
Electromyography and nerve conduction studies may be able to help show the difference between symptoms caused by pressure on spinal nerve roots and nerve damage caused by other ailments, such as diabetes.

Treatments:
It is most important to note that the majority of patients with cervical radiculopathy get better with time and never need surgery, or even any treatment at all.

Some patients will have the pain go away quickly over days to weeks, while others take longer. It is also not uncommon for cervical radiculopathy to come back at some time in the future, but again, this problem usually gets better without any specific treatment. Some patients do develop persistant symptoms and require evaluation and treatment for the arm pain or weakness.

Nonsurgical Treatment
If you are not getting better, your surgeon will recommend a course of treatment. Treatment for radiculopathy starts with nonsurgical options.

Soft Collars. Soft collars allow the muscles of the neck to rest and limit neck motion. This can help decrease pinching of nerve roots with movement. Soft collars should only be worn for short periods of time, because long-term wear can decrease the strength of neck muscles.

Physical Therapy. Physical therapy can help with neck muscle stretching and strengthening. Sometimes, traction is also used.

Medications.

Nonsteroidal anti-inflammatories (NSAIDS). These include drugs like aspirin and ibuprofen, and may be helpful if the arm symptoms are from nerve swelling.
Oral corticosteroids. A short course of oral corticosteroids may also help reduce swelling, as well as pain.
Narcotics. These medications are reserved for patients with severe pain that is not relieved by other options. Narcotics are usually prescribed for a limited time only.
Spinal injections. Sometimes, an injection of steroids can be placed near where the nerve is being pinched. This takes advantage of the anti-inflammatory effects similar to oral steroids. The injection may be placed between the laminae (epidural steroid injection), in the foramen (selective nerve injection), or into the facet joint.
While steroid injections do not take the pressure caused by a narrow foramen or herniated disk off the nerve, they may lessen the swelling and relieve the pain enough to allow the nerve to recover with more time.

Surgical Treatment
There are several surgical procedures for radiculopathy. The procedure that is right for you will depend on many factors, most importantly the type of problem you have.

I hope this helps answer your question.

Best wishes



Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Karl Logan 31 minutes later
What could be the reason for the pain extending to waist and into knee?

Am I wasting time taking the epson salt baths?
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Answered by Dr. Karl Logan 10 hours later
Brief Answer:
waist and knee pain explanation

Detailed Answer:
Hi Thanks for your follow up question.

We do see patients who because of pain and disability in one location get dysfunction and symptoms in other areas of the body and this may be because of the a protective response to minimize pain in the main area.

It could however be that your symptoms in your waist and knee are unrelated and caused by a secondary pathology such as a similar problem in your lumbar spine or a muscle sprain or strain in the muscles around your waist and osteoarthritis of your knee joint.

Epson salt baths often give good symptomatic relief for muscular problems, I use this method of treatment myself and so I do not think you are wasting your time.

I hope this further answers your question.

Best wishes
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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