Patients who are experiencing pain in their shoulder or down their arm can often be frustrated and discouraged by the difficulty of finding effective treatment to provide relief. It seems self-evident that if the pain is in the shoulder, then it must have to do with a problem with the muscles, tendons, or joints of the shoulder.
That isn’t always the case. In fact, injuries or degenerative changes in the neck that affect the nerves can produce painful symptoms in the shoulder and down the arm, complicating the task of determining the root cause of pain. How can you determine the difference so you can pursue the right treatment to restore your comfort and mobility?
The cervical spine, the seven vertebrae that make up the upper part of the spinal column, is what we think of as the neck. Each joint is connected at the back by facet joints that permit the neck to move forward and backward and to twist. Spinal nerves exit at each vertebral level, and intervertebral discs between each vertebra maintain the spacing between the bones and allow for spinal movement. The cervical nerves (C1 through C8) each serve slightly different functions. If a degenerative change like a disc herniation, facet cyst, or bone spur impinges on a nerve, it can cause serious pain, which the patient often experiences as radiating pain down their arm.
The shoulder is a ball-and-socket joint with a high range of motion. To provide stability and ensure that the head of the humerus (the upper arm bone) remains properly aligned in its socket, the glenoid fossa (socket) of the scapula is deepened by a fibrocartilage rim called the glenoid labrum. The rotator cuff, a group of four muscles that go around the ball of the joint, help to keep it in place and prevent dislocation or abnormal movement. Aging, degeneration, and repetitive over-the-head activities can cause tendonitis, inflammation, or tearing of the tendons, which in turn cause pain in the shoulder.
People who have a pinched nerve in their neck tend to have pain that starts from the back of the neck and goes into the shoulder blade area. The area affected differs depending on which nerve is involved. Confusion between neck and shoulder pain can commonly arise when the C5 nerve, which goes to the outside of the shoulder, has been affected. Usually, pain from a pinched cervical nerve does not go to the front of the neck.
Shoulder pain, on the other hand, tends to present with more pain in the front of the shoulder. This can be caused by rotator cuff problems, a biceps tendon issue, or a frozen shoulder (adhesive capsulitis, when the connective tissue of the joint becomes thick and tight, restricting movement).
The circumstances under which patients experience pain and what positions exacerbate or relieve it can also provide valuable clues as to its source. Those with shoulder problems often experience more pain when trying to lift their arm above their shoulder or head, as in putting dishes into upper cupboards. Someone with a pinched nerve, on the other hand, can experience relief of pressure on the nerve when they lift their arm, and may sleep with their arm raised. They may also sleep with extra pillows to bring their neck forward. Hyperextension of the neck or rotating the neck toward the side of the pinched nerve makes the pain worse. Patients with a rotator cuff issue will avoid laying on the affected side when they sleep and will wake up when rolling over in bed.
A physical exam will examine range of motion in the neck and arm, noting where and when pain is experienced. Sometimes, this exam can provide enough information to point to a diagnosis. X-rays and MRIs (magnetic resonance imaging) also provide additional detail on what is going on internally. However, it is important to note that as people age, the likelihood of seeing degenerative changes on an MRI go up, but those changes may not necessarily cause pain or significant dysfunction. MRI findings should be considered as part of the entire picture to determine what is causing symptoms and, more importantly, to determine an effective treatment plan.
Few things are as demoralizing as going through endless medical appointments without finding relief for your pain. Dr. Tiffany Rogers, a board-certified spine specialist with a background in physical therapy, can help cut through the confusion and determine if your shoulder pain is actually coming from your neck. Her treatment focuses on finding the least invasive, effective option to meet your treatment goals, including artificial disc replacement (ADR), a minimally invasive alternative to traditional spinal fusion. If you’re tired of getting no answers and no relief, schedule your consultation by contacting us here.
Mike was barely able to walk. I did his surgery and now he’s traveling the world with his wife! That pic is from Africa, hiked up to see mountain gorillas…
I feel very blessed to have walked in to the office for a consultation with Dr Rogers. On that day upon review of my MRI report she determined that I needed emergency surgery due to extremely compressed spinal cord at C3/4. Now I knew it was compressed for some time but I avoided going to the surgeon because I was afraid to have surgery. She calmly explained the alternatives to not having the surgery and it was a no brainer. My symptoms had gotten really bad and I knew she was right. I trusted her judgement and I am so happy that I had the surgery. Almost immediately my symptoms improved!! All of the nurses and other doctors at Torrance Memorial praised her work also and she was very well respected. I would recommend Dr Rogers because not only was my surgery a success but she also showed great compassion for me because I was very sad to be in the hospital during the Holidays. To me this shows she cares about healing the whole person.
I have Dr Rogers to thank for the rest of my life. At 12 I was told by a specialist that I was born with a deformity in my spine which was causing slight scoliosis. At 20, I started experiencing back pain, constantly feeling the need to crack my back for some relief, tossing and turning all hours of the night, seeking massages. As I started to get older, the pain only increased. By 23, my back began to “lock” on me. I would bend over or lean forward and my nerves would pitch, causing me to not be able to move for a few seconds. At first I had kaiser insurance, the “spinal specialist” if you can even call her that said there was no possible surgery to fix my spine and back pain. She told me PT and epidural spinal injections were the answer….. (wrong, very wrong!) I got this run around with kaiser for 2 years!!!!
By 25, I was BEYOND frustrated and in pain, so my (now) husband put me on his insurance, and I was able to find Dr Rogers. She requested an MRI and X-rays, and saw what was wrong with my spine and what needed to be done. I needed a spinal fusion and decompression. She even referred me to a spinal specialist in LA, to get a second recommendation, and he agreed with everything she wanted to do for my surgery. I had full trust in Dr Rogers. She was always kind, always informative, and reassured me I was going to be alright. As a fellow athlete, she understood what I was sacrificing for this surgery. My love for playing soccer would have to come to an end post surgery due to the risk of blowing out another level of my spine. She was compassionate and again gave me reassurance I would eventually be pain free and be able to carry my own children which was the most important to me.
I underwent my lumbar spinal surgery with a spinal fusion and decompression August 2016. The pain and recovery I experienced post surgery was the most pain I’ve ever felt. Pain meds helped, but you really have to be dedicated to taking the vitamins Dr Roger recommends, and doing the amazing PT she prescribed. The PT was Pilates based, and it seriously did my recovery wonders.
By March 2017, I was ready to move to another state and went in for one last check up with Dr Rogers. She did another X-ray, and told me that my fusion looked so good and healthy , that I could start playing soccer again. Not competitively, but recreationally, and now I am nearly 2 years post spinal surgery, playing on 2 soccer teams, active in the gym, and my husband and I are trying to start a family.
I still experience soreness in my lower spine if I lift too heavy of objects the wrong way or work out too hard, but that is to be expected. I have been off any type of medication spine related for over a year now, and it’s nothing a little ice won’t cure. All in all I have a lot to thank Dr Rogers for. She saved my back.
Thank you so much Dr Rogers!!!!
Dr Rogers has been taking care of my back issues for years. It came to a point that I did need a major surgery. A fusion. I am so glad it was done. Just wished I’d done it earlier. My leg pain is gone, the back spasms are gone , feeling like my ribs were stabbing me is also gone and though I’m still healing I feel so much better. I am so grateful to Dr Rogers !! I would highly recommend her for spine issues. Forever thankful!! The staff is professional and friendly also.
Update!!
It’s been a year and a half since my back surgery with Dr Rogers and I’m doing great!! Thank you again Dr Rogers!!
There are two major factors in my thinking a doctors office is 5 stars… #1 is the office and staff itself… #2 is the moment you meet the doctor and how they present themselves to you. Being someone that’s had multiple surgeries, dealt with dozens of doctors and facilities… if these two are in line when you go on your first visit, you know the experience and the healing to come will be worth it.
I have to say, the offices, ease of getting there, parking… were amazing… the staff at the front desk (and on the phone for that matter) were some of the most engaging, informative and easy to deal with that I’ve ever encountered. They made it EASY for me to check in, etc… I was taken in at the exact time of my appointment (I did listen and get there 15 minutes early) and was escorted through, had X-rays and waited for Dr. Rogers…
The moment I met Dr. Rogers, I had faith that I was in the right hands. Her eye contact, the way she shook my hand, the way she listened… the deep understanding she immediately had for my symptoms and the journey I’ve been on for the last 10 years after of my spine surgery in New York… made me incredibly calm and gave me such peace.
I see her again next week, after a battery of tests… but I look forward to finding answers with this healing doctor and her colleagues and staff…
xoxox
I am writing this review on behalf of Dr. Rogers patient, Yolanda Phelps.
Dr.Rogers performed an anterior cervical disectomy and cervical fusion on me last Tuesday. I am home now and my recovery is going great. Dr. Tiffany Rogers was so caring, thorough, and made me feel so comfortable during this difficult procedure. She took very good care of me and I am so thankful for her help.
Also her PA Jeff was so kind and helpful as well. Thank you so much you two for everything!!
PS don’t waste time going through pain go to dr. Tiffany Rogers. She does all the bells and whistles!!
Dr. Rogers is Exceptional. I am a patient of hers. I was in extreme pain Christmas week. Doctor Rogers ordered an MRI. Diagnosis was dislocated shoulder. I called her office 12/27/18. Doctor called back. She asked if I could be in her office immediately. I saw her within 1/2 hour. She injected me with Cortisone.What a God given gift!
Dr. Rogers is obsessed with the ability to heal. She went above and beyond to releive my pain.
Thank you Dr. Rogers.
I am a 72 year old female who suffered cervical disc herniation at multiple levels, resulting in severe pain in my neck and right arm. Dr. Rogers performed an Anterior Cervical Discectomy and Fusion. After surgery my pain was GONE! I was in the hospital for two days and received excellent care. I have had multiple surgeries during my lifetime but this was by far the best experience and I believe a direct result of Dr. Rogers’ experience and the care she has for her patients.
I can’t express the feelings of gratitude for Dr. Rogers and her team. About 7 months ago I started having pain in my right neck, shoulder, arm all the way to my feet. The pain worsened almost daily. Had a epidural done in the 3rd month felt good for 3 days and wham the pain, weakness was back worse than before. I went back to epidural doctor and he told me there was nothing more he could do at least for 3 months. The pain was getting so bad, l cried, became very irritable and hopeless. I started physical therapy and it seem to adjutant my worst spots. I felt hopeless and knew I couldn’t take much-more. So I made an appt with Dr. Rogers. I told her the pain had increased to a point I couldn’t stand one more day in this pain. I’m not a wimp I can endure a lot but I had come to end of pain tolerance. She showed me my xrays and I believe my right she said let’s do this. I was admitted to Torrance Memorial Tuesday around 8:30 AM.hours later when I woke up n my room, there was absolutely no pain. Dr. Rogers just happen to walk in my room. I was really medicated I grabbed her and said there’s no more pain. I owe everything to her. I love her, respect her
