Where does that Shooting Pain & Weakness into my Arm come from?

Nerve pain into the fingers, hand, forearm or shoulder is a complaint that many people at some stage suffer from. The type of pain can vary from shooting pain to simply Pins & Needles and numbness into the fingers, hand or forearm and in extreme cases it can be constant or in more common situations it can occur sporadically throughout the day. In this article I will discuss the medical names and origin of these nerves and their function, and what occurs when they are compressed. This information is very helpful in helping patients understand complaints of muscle weakness, shooting pain, pins & needles and numbness from the neck to fingers.

Our cervical spine or neck houses 8 vertebrae or bony blocks. Between each cervical vertebrae there is a Disc and a nerve on both sides. The function of these cervical nerve roots is to supply skin sensation and muscle control into the muscles and regions of the upper spine, upper chest, shoulder, arm, hand and fingers. Indeed the muscles of the hand and arm can be supplied by a combination of Nerve roots as each nerve root forms into branches of nerves as it reaches the brachial plexus which is the junction box of nerve and is situated close to the cervical spine beneath the Collar bone. So as we have 8 cervical vertebrae we have 8 cervical nerve roots. Now we will discuss cervical nerves roots C4, and C5.

C4 nerve Root

This nerve root supplies sensation and muscle control to the Shoulder region, and trapezius muscle of the upper shoulder blade region. The Spinal Accessory nerve originates from the C4 nerve root and weakness upon elevating your shoulders upwards towards your ears may indicate impingement of the C4 nerve root in cervical spine.

C5 nerve Root

The C5 nerve root supplies sensation to the deltoid muscle of the front, back and outside area of the shoulder Joint. Any abnormal sensation felt in this region can be associated with compression of the C5 nerve root of the neck. The C5 nerve also partially supplies control to the muscles of the middle and lower shoulder blade region. For example the Dorsal Scapular nerve innervates the rhomboid muscles that sit between the shoulder blades, with the Long thoracic nerve innervating the Serratus Anterior muscle that sits between the rib cage and the shoulder blade. If there is a weakness in the Patient attempting to push their shoulder blades together then there is a possible weakness of the two aforementioned nerves. Abnormal impingement on the C5 nerve root in the cervical may be present in this case.

Next week I will continue to discuss Nerve impingement of the C6 –C8 nerve root.

Tomás Ryan is a Registered Physical Therapist with The Irish Association of Physical Therapy and is based in Thurles.

Contact Number: 0504 26672

Email your queries to: info@tipp-phyiscaltherapy.ie

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Physiotherapy & Injury Rehabilitation Clinic in Tipperary

0504 26672


The Surgery, Fianna Road, Thurles


Riverside Medical Centre, 7 Upper

Irishtown, Clonmel

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