In the medical world we have many terms that indicate diagnoses and symptoms but often can be confusing, overused or utilized inaccurately to describe one’s condition. One common question I get asked by my patients that are suffering nerve-related pain in their shoulder, arm and hand is: where is this coming from?  To answer this, let’s dive in.

Nerve pain or “radiating” pain can grossly be subdivided into 2 main groups – radiculopathy and neuropathy. Radiculopathy is when a nerve is irritated/inflamed or pinched at the level of the spine. Typically, radiculopathy occurs due to pressure at the nerve root, herniated disc or bone spurring in the spinal area. If someone is experiencing pain in their upper extremity attributed to this, it is coming most likely from their cervical spine (neck). Neuropathy refers to general damage or inflammation of one (mononeuropathy) or more nerves that can occur anywhere along the extent of nerve. Neuropathy has a wider range of possible causes and can stem from localized inflammation/injury or diseases such as diabetes, toxin exposure, or genetic disorders. Common mononeuropathies seen in upper extremity are carpal tunnel at the wrist (median nerve), ulnar nerve pain originating at the elbow and radial nerve dysfunction in the upper arm.

Both radiculopathy and neuropathy can present with pain, burning, tingling, weakness and numbness that can result in difficulty with reaching, lifting items in one’s arm or losing the ability to manipulate smaller items in one’s hands making it difficult to do day-to-day tasks like dressing and using silverware.

So how do you know which is which and what to do if they can both cause similar complaints? Most often with a physical exam/screening and a thorough discussion about your medical history and daily activities with your trusted health professional can provide the right answer. Depending on the extent of pain and symptoms other testing may be needed such as MRI/CT scan to look at soft tissue and neural structures anatomy, or a nerve conduction test (EMG) to look at the health and signaling ability of the nerves. The results of these tests and discussions will aid in determining treatment. Potentially localized injections at the spine or distal areas are used to reduce inflammation as well as corticosteroids/anti-inflammatory medication. Surgery can be indicated if deemed severe and necessary.

Physical therapists are educated and trained to assist in treatment depending on origin of cause and your functional impairments to get you back to using your shoulder, arm and hand like you were before! We use an array of methods to improve range of motion, strength, coordination and stability with therapeutic exercises, manual therapy and education as well as modalities to assist in pain relief.

If you or someone you know is interested, feel free to contact me, Jill Phelan, PT, DPT, Cert. DN, Cert LSVT,  at Professional Rehabilitation Services (843) 733-3031.  I am the primary physical therapist at our Conway location and would be more than happy to further discuss and determine if treatment is right for you with a free 15 minute consultation. If you are living in another area of the Grand Strand and interested in care, please visit www.prsrehabservices.com to see the locations of our 9 other offices for your convenience.  I look forward to hearing from you!