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Injury Prevention

Med Tent: How To Treat Nerve-Based Neck Pain

This condition is more common than you think and confuses a lot of athletes.

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Nerve-based neck pain (AKA cervical radiculopathy) is characterized by sharp pain radiating into the shoulder and sometimes into the arm and hand, especially when lifting and/or turning your head. Variations include numbness, tingling and weakness.

This condition is more common than you think and confuses a lot of athletes. It causes pain in the shoulder and/or arm, and athletes think something is wrong with either one or both when the problem is actually neither. The issue is in the neck.

Your cervical spine (the part in your neck) houses your spinal cord, which has nerve roots that branch off to supply motor and sensory function to your upper arms. When you raise your head and/or twist your neck, the nerve roots can be pinched where they exit the cervical spine. Voilà, you have pain in the nerves down the line, in the shoulder or arm.

This is called referred pain, which is pain that comes from a different part of the body from where you feel it. Statistically, the most common origin of referred pain in the upper extremities is the neck, and the most common site of the referred pain is the shoulder or arm. I see this a lot, especially in cyclists and swimmers.

So what causes the problem? Your neck vertebrae being out of alignment, or having a degenerative condition like arthritis or bone spurs, but the most common cause in young and middle-aged athletes is having a herniated cervical disc that’s compressing a nerve root.

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Fix It

See a doctor. It’s smart to see a doctor for this radiating arm or shoulder pain because a proper diagnosis usually requires some detective work.

Employ dynamic rest. Avoid any activities that engage the neck and shoulders. Use lower-body workouts to maintain fitness.

Ice it. Apply ice to the neck for 15 minutes 4 to 6 times a day for the first 2 days.

Try an NSAID. An anti-inflammatory like ibuprofen or naproxen can help with swelling and inflammation.

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Prevent It

Recondition your neck and shoulders. Having properly conditioned muscles in your neck and shoulders can help keep everything in its place. The stronger and more flexible the muscles, the more support your spine has, which can prevent nerve compression. Your regular upper-body workout should include lots of overhead shoulder work, as well as the resistance exercises mentioned above that specifically target your neck. Do yoga and Pilates workouts regularly for overall kinetic chain conditioning.

Watch your posture. Lousy posture in an office chair for hours each day can contribute to neck problems. While sitting, imagine that there’s a straight line from your ears down to your hips. Your shoulders should be back and open, feeling as if they’re resting on your shoulder blades. This keeps your body aligned and promotes good breathing. Get up, move around and stretch at least once an hour.

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Reestablish Range Of Motion

As pain improves, try the exercises below to help recondition your neck and shoulders. Once you’re pain free, move on to more aggressive neck and shoulder conditioning to help prevent the problem from recurring.

Neck Stretches
Stand with your hands behind your neck. Bend your neck back and look at the ceiling. Squeeze your shoulder blades together. Hold for a moment and return to the starting position. Work up to 10 reps. Also, try basic head rotation to the left and right, as well as tilting your head to the left and right, for up to 10 reps each.

Basic Resistance
Do the same movements just described, but change them to resistance exercises by using your hand to prevent your head from moving, i.e., by putting your hand on the right side of your head and trying to tilt your head to the right while your hand prevents it. Hold for 5 seconds. Do this for tilting your head left and right, turning your head left and right, and bending your head forward and backward. Do 10 reps of each movement.

Shoulder Rehab
Shoulder shrugs, holding at the top for 5 seconds, are effective. Another good exercise: Stand with your arms at 90-degree angles in front of your body. Rotate them to the sides as you squeeze your shoulder blades together. Hold for 5 seconds and return to the starting position. Do 10 reps.

More Med Tent

New York City sports medicine specialist Jordan D. Metzl, M.D. is a 33-time marathon finisher and 13-time Ironman. His book, The Athlete’s Book of Home Remedies, has more than 1,000 tips to fix all types of injuries and medical conditions.