The most common source of neck, shoulder, and arm pain in adults is pressure on the nerves in the cervical (neck) spine. Pain is often accompanied by a feeling of “pins and needles” or the sensation of the skin “being asleep”. Although we have all experienced this numbness at times, persistent daytime symptoms usually point to a structural problem.

If your physician’s exam finds nothing wrong in the shoulder, there may be a cervical disk problem. The disks are the “shock absorbers” between the vertebrae and the nerves can be trapped by a piece of displaced disk. Often a complete exam and x-ray can point to the problem, although sometimes an MRI is required.

Initial treatment for most “nerve” pain is rest and anti-inflammatory medication, such as Advil or Aleve. If pain persists, physical therapy can be useful, especially with short periods of traction. More resistant cases may require cortisone injections, known as “epidurals”. These are performed by pain management specialists.

When pain is severe, or when nerve compression causes significant numbness or weakness, surgery should be considered. The most common surgical approach is a small incision in the throat, known as an “anterior diskectomy”. The entire disk is removed and then fused with bone graft to prevent further degeneration of the disk. Another approach is “posterior”, or through the back of the neck, removing just that portion of the disk that is rubbing on the nerves. If the correct approach is chosen, success rates are expected to be above 95%.