Is Your Shoulder Pain Related to Your Numb Hands or Fingers?

Damaged or pinched nerves may be linked to pain in the shoulder as well as numbness in the hand, including the fingers. If you’re experiencing these symptoms, you might have tried shaking or rubbing your hand to regain normal sensation. You may have also noticed that your affected hand feels weaker, making it more difficult to hold or grip objects.

Several medical conditions can cause shoulder pain and hand numbness. These conditions typically impact a network of nerves called the brachial plexus. The brachial plexus originates near the top of the spine, runs through the shoulder, and branches down into the arm and hand.

While it’s possible shoulder and hand symptoms will go away over time with home treatment, keep in mind:

• Whenever pain is accompanied by numbness, weakness, tingling, or pins-and-needles, it is a good idea to consult a physician for a diagnosis. He or she can recommend a treatment plan based on the diagnosis.
• Immediate medical care is recommended if you’re in severe pain or your symptoms affect both sides of your body. Immediate care is also recommended if you experience severe weakness, uninterrupted numbness, or difficulty moving your hand, arm, or shoulder.

Timely medical treatment may help prevent or minimize long-term problems.

Below are 4 medical conditions that are often the cause of shoulder pain and hand numbness:

1. A pinched nerve root

Nerves control feeling and movement, and a pinched nerve root can cause numbness, weakness, and/or a pins-and-needles sensation in your hand or arm. Pain may be felt in the shoulder as well as the arm and hand. This pain can range from a constant, mild ache to an intense, recurring burning or shooting pain.

• Pain and other symptoms, such as numbness and weakness, typically appear at the same time.
• Certain neck movements may make symptoms better or worse.
• While pain is more likely to be felt in the neck than in the shoulder or upper chest, not everyone with a pinched nerve root will experience neck pain.

Symptoms may appear gradually or suddenly.

Read more about Cervical Spinal Nerves and Cervical Radiculopathy on Spine-health.com

What causes a pinched nerve root?

Nerve roots are located where nerve tissue branches out from the spinal cord. The nerve roots pass through small spaces between the spine’s vertebrae, called foramen. A nerve root can become pinched at or near the foramen because of inflammation and/or mechanical pressure.

Inflammation and pressure may be related to a one-time injury or:

• A bulging or herniated disc. The affected disc presses against a nerve root. Also, when a cervical disc herniates, inflammatory proteins can leak out of the disc and inflame nearby nerve roots.
• Bone spurs (osteophytes). The growth of one or more bone spurs can cause a foramen to narrow, and the nerve root that travels through it can get squeezed. This condition is called foraminal stenosis.
• Arthritis. The degeneration of joints between vertebrae in the neck is called cervical osteoarthritis. Like bone spurs, arthritis can cause foraminal stenosis.
• Changes to a ligament(s). A ligament is a strand of fibrous connective tissue. A ligament can thicken and harden, a process called ligament ossification. The affected ligament, which may be just 2 mm or 3 mm thicker than normal, can press against a nerve root.¹Liang H, Liu G, Lu S, et al. Epidemiology of ossification of the spinal ligaments and associated factors in the Chinese population: a cross-sectional study of 2000 consecutive individuals. BMC Musculoskelet Disord. 2019;20(1):253. Published 2019 May 25. doi: 10.1186/s12891-019-2569-1

Less common causes include inflammation from a spinal infection or abnormal growth (cancerous or noncancerous).

Read more about Neck Pain Causes on Spine-health.com

Medical imaging, such as magnetic resonance imaging (MRI), may be used to help determine the underlying cause of a pinched nerve. Treatment recommendations may vary depending on the underlying cause.

2. Brachial plexus injuries (including stingers)

Nerve tissue can be strained or damaged anywhere—not just at the roots. An injury to the brachial plexus in the neck, upper chest, or shoulder may cause pain, numbness, and weakness in the shoulder as well as the arm and/or hand.

One type of brachial plexus injury is called a stinger, or burner. Stingers may cause brief, temporary symptoms, including:

• Pain that feels like a sudden electric shock or burning sensation
• Warmth, tingling, pins-and-needles
• Weakness in the affected arm or hand

Stingers are usually relatively minor injuries, and symptoms often last just a few seconds, minutes, or hours. After the brief, initial symptoms subside, neck pain, muscle spasms, or cramps, may develop.

More serious brachial plexus injuries are also possible. These serious injuries can cause symptoms that are more severe and longer lasting; if the injury goes untreated or cannot heal, symptoms may be permanent.

What causes a brachial plexus injury?

Trauma can cause the brachial plexus to be overstretched or to tear. For example, damage can occur if a person’s head and shoulder are forced in opposite directions during a fall, sports-related collision, or motorcycle or car accident. Other potential causes for injury include the growth of tumors that can press against the nerves, radiation treatment to the chest, and trauma from surgery.

3. Brachial neuritis

Brachial neuritis refers to the inflammation of the brachial plexus. This relatively rare condition can cause pain, tingling, numbness, and/or weakness anywhere along the brachial plexus pathway, from the neck and shoulder all the way down into the arm and hand. About 20% of cases affect both sides of the body.²Al Khalili Y, Jain S, Lam JC, et al. Brachial Neuritis. [Updated 2022 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499842/

• In contrast to a pinched nerve, brachial neuritis is more likely to cause weakness in the upper arm and less likely to cause neck pain.³Miller JD, Pruitt S, McDonald TJ. Acute brachial plexus neuritis: an uncommon cause of shoulder pain. Am Fam Physician. 2000 Nov 1;62(9):2067-72. PMID: 11087188.
• Shoulder or upper chest pain usually appears first. The pain may be severe and last a couple of hours or even weeks and then go away as other symptoms appear, such as upper arm weakness or hand tingling.³Miller JD, Pruitt S, McDonald TJ. Acute brachial plexus neuritis: an uncommon cause of shoulder pain. Am Fam Physician. 2000 Nov 1;62(9):2067-72. PMID: 11087188.
• Neck, shoulder, and arm movements typically do not make the pain better or worse.³Miller JD, Pruitt S, McDonald TJ. Acute brachial plexus neuritis: an uncommon cause of shoulder pain. Am Fam Physician. 2000 Nov 1;62(9):2067-72. PMID: 11087188.

Symptoms can appear suddenly and typically go away within days to months. It’s rare for this condition to become permanent, especially if treated.

What causes brachial neuritis?

Inflammation of the brachial plexus may be associated with a chronic disease, such as systemic lupus erythematosus (SLE) or Ehlers-Danlos syndrome. It may also be associated with an infection, even weeks after recovery, when infection symptoms are gone. Sometimes, there is no clear underlying cause.

Read more about Brachial Neuritis on Spine-health.com

4. Thoracic outlet syndrome

The nerves of the brachial plexus must pass through a narrow space between the collarbone and ribs called the thoracic outlet. Blood vessels (arteries and veins) also pass through this space. If the space becomes too small the brachial plexus or blood vessels can get squeezed. This squeezing leads to a variety of symptoms referred to as thoracic outlet syndrome.

At least 90% of thoracic outlet syndrome cases affect the brachial plexus nerves.⁴Kaplan J, Kanwal A. Thoracic Outlet Syndrome. [Updated 2021 Apr 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557450/ Doctors call this neurogenic thoracic outlet syndrome, and its symptoms include pain, numbness, tingling, or pins-and-needles, and weakness in the upper extremity. In addition⁵Khadilkar SV, Khade SS. Brachial plexopathy. Ann Indian Acad Neurol. 2013;16(1):12-18. doi:10.4103/0972-2327.107675:

• Symptoms may get worse with certain movements, particularly raising the arms overhead.
• Symptoms may be worse at the end of the day, after activity, or in the morning, after sleeping.
• Numbness, tingling, or pins-and-needles are most likely to be felt in the pinky and ring fingers.

When thoracic outlet syndrome involves the blood vessels, you are likely to feel a general, aching pain as well as swelling, discoloration, and/or bulging veins. Certain arm movements may cause the pulse in the wrist to slow down or stop. Problems with blood flow can be a medical emergency.

What causes thoracic outlet syndrome?

Like other brachial plexus injuries, thoracic outlet syndrome may be caused by an injury or trauma, such as whiplash. It may also be the result of unusual anatomy: about 0.5% to 1% of people have an extra rib that extends from the base of the neck, creating an even tighter space for nerves and blood vessels.

Other potential causes include repetitive overhead movements, poor posture, and changes in anatomy, such as weight gain, the development of muscle tissue, tightened muscles, pregnancy, and the growth of tumors.

Read more about Neck Pain from Thoracic Outlet Syndrome on Spine-health.com

Treatment to relieve shoulder pain and hand numbness

Symptoms depend on which brachial plexus nerve has been damaged, where it has been damaged, and how severely it is damaged. In most cases, shoulder pain and hand and finger numbness will go away with treatment. Treatments can range from rest and over-the-counter pain relievers to cortisone injections or even surgery. Getting an accurate diagnosis of the underlying cause increases the chance that treatment will work.

When symptoms are severe, immediate medical care is advised to help prevent further or permanent damage.

Read more about Hand Pain and Numbness on Spine-health.com

Learn more:

Guide to Shoulder Anatomy

Soft Tissues of the Shoulder