We MDs have traditionally made fun of chiropractors, but more and more research is showing that what they do works. In addition, the concepts first introduced by DD Palmer back in the 1800s, that the nerves in the spine could impact what happens elsewhere in the body, were way ahead of their time. While he may not have understood all of the details, the concept was accurate. This morning let’s take a look at a new study that supports what your local chiropractor has been saying for years. The key to what happens in your shoulders, arms, and hands is in your neck.
The Cervical Spine Tells Your Shoulder Muscles What to Do
The cervical spine and shoulder are more than just next-door neighbors. In fact, the cervical spine at the C5 level communicates with the shoulders as the C5 nerve actually innervates (supplies nerves to) the shoulder muscles and tells them what to do. Pressure on the C5 nerve, therefore, can cause shoulder weakness. Hence, if chiropractic manipulation of the neck works to help reduce pressure on the nerve, we should see more shoulder strength. For more info on how nerves in your neck could impact your shoulders and arms, take a look at my video below:
Shoulder Strength Increased After C5 Manipulation
The new study was a randomized controlled trial with 65 patients in the test group and 60 patients in the control, or placebo, group—all of whom had extreme shoulder pain that was thought due to an issue in the cervical spine putting pressure on the C5 nerve. Chiropractic adjustments were made at the C5 level to the test group using a mechanically assisted instrument (a small adjustment tool rather than manual adjustment) at the highest setting; the instrument was not activated in the control group. Twenty-four weeks following treatments, investigators looked at pain (frequency and severity), function, range of motion, and strength in the shoulder.
The results? Researchers found improvements in pain frequency and shoulder strength, leading them to conclude that adjustment at the C5 level (in this case using the mechanically assisted instrument) does indeed work to address shoulder strength.
Other Ways the Neck and Shoulders Work Together
The muscles in the neck and between the neck and shoulder also play a key role in both neck and shoulder strength. Connecting the shoulder blade to the neck, head, and upper back is the trapezius muscle, and this one is notorious for becoming tight and painful with certain motions or repetitive movements (such as constantly looking down at that smartphone). It can be easy to assume that shoulder pain must be due to a problem in the shoulder, but oftentimes the problem is actually stemming from an irritated nerve in the neck.
Even when there are known rotator cuff tears in the shoulder, it’s important to also have your neck examined as research has shown that rotator cuff tears can exist with or without pain. So just because an MRI shows the tear doesn’t mean it’s causing the pain. Problems in the neck need to be ruled out before diagnosing the rotator cuff tear as the cause of shoulder pain.
What Can Be Done if Manipulation or PT Doesn’t Work?
We’ve seen great success with precise injections of platelet lysate (PL) around the irritated spinal nerve in the neck. For more information on how PL differs from platelet-rich plasma (PRP), see my video below:
The upshot? We MDs owe a great debt to chiropractors. They figured out, long before we did, that the nerves in the spine were critical to how well our shoulders, arms, and legs work. That’s why we always try to treat the whole person. Meaning when a patient shows up with shoulder pain, it’s critical to make sure that the neck is checked!