What causes arm pain & shoulder pain?
In most cases where there is a combination of arm pain and shoulder pain, the cause arises from entrapment of nerves within the neck or where these may be pinched between the clavicle and the chest wall. For the sufferer, where neck pain is not evident and once causes in the shoulder itself have been ruled out, the source of the pain may be elusive because the actual causes of arm & shoulder pain can be difficult to locate using conventional diagnostic techniques.
Why is the pain so hard to locate?
Conventional diagnosis relies upon patterns of pain, clinical examination and MRI scans. These may be inconclusive. The scan may only show mild degeneration of the intervertebral discs; often referred to as a degree of ‘wear and tear’ simply from modern daily living. However this may have resulted in an alteration in posture that has either allowed the nerves to be nipped in the neck, between the clavicle and the chest wall or has overloaded the flexion or extension of vulnerable discs. At the same time, nerves related to the arms and shoulders follow a long pathway as they exit the spinal column and are thus vulnerable to problems at more than one point and multiple causes may be involved.
How is arm pain and shoulder pain diagnosed?
Analysis of the neck and shoulder posture is essential to detect the abnormal movements and posture of neck, shoulder blade, clavicle, shoulder and arm. If this is correct, then the causal pain sources in the neck can now be accurately defined through aware state surgical examination, where the surgeon seeks to replicate arm & shoulder pain by probing the structures on and around the discs. When this provokes a response, the patient, who is protected by circulating intravenous pain killers and sedation, offers feedback to the surgeon regarding the type and distribution of the pain produced. Sometimes, when the response is only partially akin to the presenting symptoms or when the response is at more than one spinal level, additional techniques are deployed to determine the relative importance of each site in the totality of the patient’s pain and condition.
Why is this better than conventional diagnosis?
This ‘live’ approach to diagnosis means that causes of arm & shoulder pain can be defined and ultimately confirmed so that misleading diagnoses caused by strange nerve links in the neck can be avoided. Subsequent endoscopic examination, with the patient awake, then leads the surgeon to the precise source of pain at the specified intervertebral level. This is in contrast to conventional diagnostic techniques that rely on pre-operative ‘guesstimation’ based upon X-rays, MRI scans and CAT scans - and often result in the “overkill” of multiple level surgery performed to attempt a treatment ‘catch all.’
How is arm & shoulder pain treated?
Once postural correction has been attempted, and following aware state diagnosis, the patient is treated using Endoscopic Minimally Invasive Spine Surgery or Percutaneous Laser Disc Decompression. This facilitates accurate clearance of degenerate products within the disc and enables compressed or trapped nerves to be relieved by shrinking the posterior wall of the disc. At the same time leaks and tears in the wall can be sealed and bone spurs projecting from the vertebra and facet joints pinching the nerves can be removed.
Why is it better than conventional surgery?
The great benefit of Endoscopic Minimally Invasive Spine Surgery and Percutaneous Laser Disc Decompression is that they enable the surgeon to treat the condition specifically, precisely and with minimum collateral damage to tissues, reduced risk to the patient and enhanced long-term outcome. Again, this is in contrast to conventional surgery, especially where multi-level conditions are suspected. Under these circumstances, the surgeon will treat all the involved levels using ‘overkill’ multi-level surgery with its problems including blood loss, potential nerve and tissue damage, extended post-operative care and unnecessarily operating on non-causal levels. Minimally Invasive techniques can be used in all age groups but offer treatment for the frail, the infirm and the elderly because they avoid the use of General Anaesthesia. They also open up the opportunity to treat long term symptoms where the diagnosis is in question to the conventional surgeon and where the patient is therefore referred for palliative Chronic Pain Management.