What is causing nerve pain in my shoulder and arm?
Pins and needles in arms at night
For many of us, falling asleep at night is often not an issue. It’s what happens while we’re sleeping that causes the problems. Pins and needles in your arm at night can range from being a mild annoyance; to a troublesome interference with getting a good night’s sleep. But what is causing this nerve pain to happen? And how can we prevent it from happening? In this article, I will discuss,
- What creates nerve pain in my shoulder and arm?
- Entrapment point for nerves of the arm.
- Stretches to help ease nerve pain in the shoulder and arms.
- Sleeping advice for pins and needles in the arms.
Let’s begin by looking more deeply into our neck, chest and wrist anatomy. All these areas can be entrapment sites for nerve pinching, which can create dead arms, pins and needles down the arm and into the fingers, numbness, aching or burning pain, or muscle weakness.
The Brachial Plexus is a network of nerves that sends movement sensory signals from the spinal cord into the neck, shoulders and arms. Originating from the backbones of the neck, this nerve bundle then travels down underneath the first rib and continues into the armpit area. From the axilla, it branches out to form the nerves that supply the arm: The Ulnar, Median and Radial nerves. The trajectory of this upper body intervention is relevant due to the potential nerve entrapment sites it meets along the way. We will take a closer look at these now.
Nerve compression in the neck
The first group of muscles that may be causing nerve pain in the shoulders and arms is The Scalenes. Comprised of three muscles, and set deep into the lateral compartment of your neck, restrictions in the scalenes can exert pressure on the brachial plexus.
One indicator that nerve entrapment may be coming from here is that you feel sensations referring down the lateral side of the forearm into the thumb, 1st, and lateral side of 2nd finger. The medical term for nerve pain in the arm and shoulder stemming from here is Thoracic Outlet Syndrome. Other symptoms include pain between the shoulder blades or finger-like projections down into the chest.
The Pectoralis Minor:
A second potential site for upper limb nerve compression is in the chest. The Brachial Plexus runs deep to the pectoralis minor, a muscle attaching to the outer edge of the collarbone, which fans out via three muscle heads into the deep chest. In difference to the scalenes, pec minor trigger points refer down the medial side of the arm and possibly as far as the 3rd, 4th and 5th finger. You may hear the term Pec Minor Syndrome used to describe nerve-related symptoms stemming from here. Other expressions of restrictions in the pec minor are anterior deltoid pain and pain in the front of the chest, which can mimic angina on the left-hand side! You may also have problems reaching forward and up.
The Carpal Tunnel:
A third site that may be causing pain in your arm is the wrist. It’s here that we find the carpal tunnel: A compartment at the base of the palm, which the tendons of the front of the arm and the median nerve travel through to reach the fingers. The median nerve originates in the brachial plexus and innervates the entire arm with muscular signals.
Median nerve compression is felt in the thumb, first finger, middle finger and lateral side of the ring finger. However, true carpal tunnel syndrome (due to inflammation or damage to the flexor tendons pressing on the median nerve as it passes through the carpal tunnel) is uncommon and often misdiagnosed. In most cases, it is far more likely that the problem is arising from further up the nerve lines, as described before.
Self-care techniques for nerve pain in the shoulder and arm
- In a seated position, bring one hand behind your back with the palm facing out. This action will prevent the shoulder from rising up to compensate for any restrictions in the Scalenes when putting them on a stretch.
- Drop your ear to your shoulder on the opposite side, using your other hand to apply a gentle bit of extra pressure if needed.
- After around five slow breaths, take your chin towards your chest slightly. The slight angle shift will allow you to target the posterior scalene more.
- Next, tilt your chin slightly up and away to access a deeper stretch in the anterior scalene.
- Mindfully help your head back to the centre and repeat the other side.
This stretch is a great one to do at your desk throughout your working day. It’s also particularly effective when done after a warm shower or bath.
Pec Minor opener:
- Lie on your front and extend one arm out to the side at roughly a ninety-degree angle.
- Using your other hand as a lever, roll onto your side towards the outstretched arm so that it’s behind you.
- You may need to bring a cushion or block underneath your head for support. You should feel the stretch in the front of the chest and shoulder.
- If you want to deepen the stretch, then bring your top leg bent behind you and roll open more towards the ceiling. Roll forward for less intensity.
- If this exercise recreates any of the nerve pain symptoms you’ve been experiencing, then back off with the depth of the stretch or change your arm position behind you.
A gentler alternative to this stretch is one that you can do in bed. Lie with your spine stacked along some pillows lengthways. Make sure your sit bones are on the bed, with your head supported. Once lying back in position, bring your arms out to either side of you into a T-shape with the palms facing up. Feel the stretch across the chest and relax into it for as long as is comfortable.
The Wrist decompressor:
- Wrap around your wrist with the thumb and first finger of your other hand. Keep the wrist neutral.
- Use deep and slowly applied pressure from your thumb to drag down across the wrist in a stripping motion. As you do so, slowly take your wrist into extension by drawing your fingers away from your body and down to the floor.
- Bring the wrist back to neutral each time you complete a wrist strip and extend the wrist as you drag down across the wrist.
- Work your way methodically, stripping and extending the wrist from the thumb side to the little finger.
This exercise is excellent to do if you have a job which involves lots of typing. Why not try practising it whilst watching TV in the evening?
Read also Neck & Shoulder Pain – Home Help SOS
Sleeping advice for nerve pain in the shoulder and arm
Dead arms at night or pins and needles whilst sleeping are more commonly experienced by the side-sleeping population or those who sleep on their fronts with their arms overhead. Whilst it can take a little while to reprogramme yourself to do it, sleeping on your back is preferable. Try creating little barriers with cushions on either side to prevent yourself from rolling over.
You may also want to try different pillow heights to see if that makes a difference to the quality of your sleep. No need for overpriced orthopaedic pillows! Instead, try combinations of hard base pillows and softer top ones to cushion into the neap of your neck. However, somewhat frustratingly, pillows are a personal preference, which can take some experimenting to get right!
Manual Therapy for compressed nerves in the neck, shoulder and arm
Whilst there are undoubted benefits from including the above stretches in your daily routine, there is no denying that the greatest gains will come from working with an experienced manual therapist. Any clinically trained bodyworker should be able to help you release restrictions in any of the brachial plexus entrapment sites. Through a combination of trigger point therapy, fascial work, soft tissue release techniques, neuromuscular facilitation and mobilisations, it should be possible to work with a therapist to dramatically reduce or even get rid of your nerve pain symptoms altogether. And the great news is that many people even manage to avoid invasive surgery by going down this route.
If you are suffering any of the symptoms mentioned in this article and would like to discuss the possibility of working together on an advanced clinical massage treatment plan, then please feel free to get in touch with your questions. I also run weekly online mindful movement and rehab classes, which come with a free video recording included with the class booking.
Wishing you all a peaceful night’s sleep.
Emma Wall (ACMT) – [email protected] / 07480 939652