Is Your Neck, Shoulder & Arm Pain from a Pinched Nerve or Muscle?

top and bad but to motivate this

physical therapist on me today hi folks

I'm Bob Shrum physical therapist Brad

hanok physical therapist together we

have the most famous physical therapist

on internet and our opinion of course

Bob Brad today mr. Hynek you talk about

is your neck or shoulder pain coming

from a pinched nerve or actually from

muscle right it's a common question and

a very valid question and it's it's what

we do a therapist all the time we need

to determine is it from the nerve being

pinched in the neck the spine or is a

muscle just contracting and knotting up

from the activity that you're maybe

doing so you got to get to the bottom of

it that's right if you treat the muscle

and it's a nerve you're wasting your

time right and there's different ways to

treat the two so that's why we'll do a

little at the end we'll show just to

some basic triggers oh by the way if

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get to the main the main venue Bob

alright let's go okay so turn around

once Bob Bob comes in he the patient he

said oh I got pain here and here and

it's on one side and it's over here and

it's all tight knotted up and it's at

work and he's on the computer it's

getting so bad he's getting headaches

and everything else how we're going to

treat it so I'm thinking we got a we

like you discussed is it an herb or is

it the muscle itself so the first thing

I want to do is screen out is it a nerve

and these are things you can do at home

and you'll find out very quickly what we

have here well the first thing is

location I get specifics on the location

if Bob says oh it's here is painful here

and you also get some

symptoms being pain numbness tingling

down below the elbow it's pretty much

more likely nerve yeah nerves getting

pinched somewhere yeah if the pain or

symptoms that means numbness tingling

burning anything unusual goes down below

the elbow almost certainly a nerve okay

so that makes it easier it's at that

location that's the simple one if it

stays up in here then it could go either

way right okay

it just might be a nerve that's not bad

enough exactly you could turn around

what's problem okay now face them so

this is what I'll do Bob and I screen a

little bit differently but one thing you

can do is a gentle test what there's a

Sperling test or a chance for you turn

and go back like this right

do that again site slight turn to the

right to the right and then you've been

back a little bit and that's assuming

the pain is on this on the right side

exactly that's some gentle pressure

pressure and if that increases the pain

and symptoms over here or send some down

the arm it's pretty sure it's somewhere

he's putting more pressure on a nerve

exaction or exactly and you can do it on

the other side to turn and go back yep

and then gentle pressure in front gentle

pressure okay the other one this is kind

of a screen that's not real specific but

I use it and with some experience I feel

pretty comfortable but as laypeople it

will be helpful thing yep just just to

the opposition time I asked a person

just look back up and usually I have

them in a chair where there's a back

rest so you can lean into that be more

relaxed now bob gets halfway back and

I'll and say the owl it hurts hurts back

in here or down the arm anything that

goes down on the arm you're pretty much

certain it's a nerve yeah if he gets

stuck halfway back is all that really is

uncomfortable and I don't want to go any

further because normally go back in

normal range of motion all the way

because actually you would spec if they

go back all the way like that and

there's no symptoms at all lesser then

they started thinking it's not coming

from the neck and maybe it is just the

muscle exactly astral thing exactly

wrong so what what I do want to do is

just spend just a brief second here to

show you what's going on and where the

nerve oh thank you Bob here's here's a

spine in here is the first seven

vertebra are the neck we got that

focus Julie's here to help Julie cheer

today Julie yes so and these yellow

things coming out are the spinal nerves


and he actually don't get cut off like

this they go all the way down into the

arm exactly Shannon sensation and you

can see where they go and you got that

in Julie there's not a real large area

it's called a Freeman where that nerve

goes in at every level and it's usually

the lower ones that get pinched but it

could be a number of reasons why that

nerve gets pinched in Scent painted

we're not going to get into the

arthritis could be just inflammation

right could be gnosis could be a disc

problem so okay so once you go through

those screens everything is negative you

don't get any symptoms down the arm you

can bring your head all the way back

your range of motions reasonably good in

the neck it's probably a muscle problem

and in Bob's case he already told me I'm

just doing a mock thing here he already

told me that I'm at work I'm at the

computer and it gets so tight back here

and curtsies busy I work a lot of stress

going on to get things done no brakes

yep and then next thing I'm going to do

is I'm going to tell pate or feel the

muscles in the upper traps and I do that

and they're just tighter than tight and

painful great and I'll find a trigger

point in there here now that really kind

of opens the bag up said oh that's right

yeah yep those are those are all things

that are singing you know we're looking

at muscle here exactly okay so why the

muscles create so much pain just from

either and this is what Bob and I are

we're just talking about this before

most of the time if you're at a computer

you're sitting and you got pain back in

here it's likely a posture problem right

exactly and it's a high most most muscle

issues our posture yeah exactly

and head forward posture very common

there you go so I want you to come over

here sure now put your head forward Bob

or there you go now this is how Bob's

looking you give them a profile of it

there we go and I'll go back that way so

what's going on is Bob's heads hanging

there over nowhere and these muscles

back here have to contract this

represents the upper trap muscle and

that's not the only one working here

there's 58 years yeah there's skin

there's other muscles but we're going to

focus on one muscle if this muscle upper

trap is working more to help keep his

head from falling down go ahead if you

can't work where you had fall down so

the muscles keep it up and these muscles

are postural muscles they're made for

holding on and postures for long periods

of time but not really long we're not

talking hours we're talking about 20

minutes and then the muscles you get a

break and allow it to relax so we're

going to take a look at this muscle and

talk about why this muscle right back in

here gets so tight and painful okay

again a postural muscles a big broad

muscle lot of surface area so there's a

lot of area for blood and capillaries to

go into it so muscle has to have blood

oxygen nutrients in order for it to

function okay just like down here this

is the basic function of the muscle this

represents a muscle you see the nice

fibers of my lab yeah well done

yeah I'm an RVT now the blood fall this

represents an artery coming in and it

drops off into the capillaries and all

the finer areas of the blood regulation

circulation that goes in and feeds the

muscle blood oxygen and nutrients of the

muscle contract and maintain as a job

and a muscle as a result produces carbon

dioxide lactic acid uric acid a lot of

waste Prodigy's products they have to

leave the muscle and they have to go

back into the system of your body we

circular recycles it so to speak okay

now if this muscle becomes tight right

okay just like this most like a sponge

if a sponge is relaxed

it can exert a lot of water just like

muscles if muscles are relaxed they can

absorb a lot of blood flow if they

tighten up and you squeeze all the water

out of this or the blood gets squeezed

out of a muscle you can't get blood back

into it because it's tight right okay

like a sponge you loosen up water will

absorb if you loosen up a muscle and the

nutrients they are the waste products

can go out right and the fresh blood can

get in so it's a whole cycle so this

posture tight muscles for hours on end

is going to create pain you got that

lactic acid in that muscle that's not

getting out of there just think of that

as they're building up and burning and

and that's why you're going to find out

we need to stretch that muscle and get

it moving

so they get blood flow into it and the

way from exactly so so the first thing

we're going to do is change your posture

so a blob head is this head forward

posture I'm going to say brab you got to

change your ways a little bit so I'm

going to go like this get them up here

tuck that chin in a little bit trying to

line up the ears with the shoulder you

go that allows these muscles not to have

to work near so hard a lot of times

those muscles once they get tight they

kind of stay tight yeah they do you got

to work about hard to break it okay the

tightness so they got a tool called

lunch of God that oh yeah Bob

this is the theracane opt piece LZ up

calm and this works out really well you

can just you can work your way into

those muscles here you can just do point

pressure like pressure right on the

trigger point or you can actually I

actually use it as almost a massage

reserve gets when I work it down like

that all right

like I said getting more blood flow to

the area great really a nice way to to

get things moving I liked it right

and then just stretching the muscle

right so you can do a side stretch over

here now you're not going to stretch

really hard these are thin broad muscles

and you don't want to pull hard you try

gentle my fingertips is all I'm doing

that's going to get that scalene muscle

I talked about if you go forward looking

down your pocket gentle stretch that'll

get that upper trap a little bit levator

scapulae okay typically we don't teach

to stretch down though okay now I can

cause other issues right so to the side

and down and angle in both direction and

I would say shoulder shrugs Brad just

getting things moving here everything

off and you know you know these are

these are the ones you could should be

doing throughout the day right certainly

you could do every hour if not every 20

minutes right so I am bringing up I

squeeze them back one two three four

five six seven eight nine ten relax okay

you do five of those and you'll find

things are loosening up exactly chin

tucks is another good one yeah you're

sitting there it's going to help you

remind you to keep good you're aligned

yeah you know you don't have to push in

with your hand I always do because it

gives me a little more stretch make sure

your computer screens up high enough you

don't want to be down here moving so

you're looking at the screen and not

down is writing and and in some heat you

write just hot

at $1 get you know I'm not big on hot

tubs because I think it's a lazy persons

way to work out sure in this case I

think it's going to loosen up the muscle

and do well with it

all right I'll buy one now Brad Jesse

said that was pinched nerve Brad I guess

we got whole videos on that right I

don't know that we want need to go into

that if there's a pinched nerve yep

you're going to have to go into one of

our videos for a neck pain with arm

pride yeah exactly so all right this is

related to our problem that we can't

solve it but this is this a big part of

it Bob all right yeah we can fix

anything except for I'm gonna put the

broken heart right here yeah right now

they standing he's up but a broken heart

okay so we're trying we're working at it