Cervical degenerative disc disease is a common cause of neck, shoulder and arm pain that is caused by the breakdown of the discs in the cervical spine.
Degenerative disc disease can cause shoulder and arm pain, especially if the condition affects the cervical spine (neck region).
Degenerative disc disease is not exactly a disease, but a degenerative condition that, when symptomatic, causes pain and affects the quality of life, limiting essential activities such as walking, lying down, and sitting, among others. Considered a common disorder, as it is a consequence of aging, disc degeneration affects 35% of people aged 20 to 39 years old and about 100% of older adults over 60 years old[1]Battié MC, Joshi AB, Gibbons LE. Degenerative disc disease: what is in a name?. Spine. 2019 Nov 1;44(21):1523-9..
When upper back or shoulder pain is accompanied by arm numbness, it could result from a neck or shoulder problem that has inflamed one of the nerves that runs down the arm.
Degenerative disc disease, when symptomatic, causes pain and stiffness, among other symptoms, as they arise according to the location of the intervertebral disc[2]Hemanta D, Jiang XX, Feng ZZ, Chen ZX, Cao YW. Etiology for degenerative disc disease. Chinese Medical Sciences Journal. 2016 Sep 1;31(3):185-91.
When located in the cervical disc, disc degeneration causes pain in the neck region that can radiate to the shoulders and arms and even reach the hands. There may also be tingling, numbness, muscle weakness, reduced sensitivity in specific regions and decreased involuntary reflex[3]Korinth MC. Treatment of cervical degenerative disc disease–current status and trends. Central European Neurosurgery-Zentralblatt für Neurochirurgie. 2008 Aug;69(03):113-24..
Some people may experience worsening back pain and numbness in their arms throughout the day, while others may experience worse symptoms upon waking in the morning.
Causes of Degenerative Disc Disease
Degenerative disc disease can be caused by a variety of factors, including aging, genetics, and lifestyle choices. As we age, the discs in our spine can naturally degenerate and lose their elasticity, which can make them more prone to injury.
Genetics can also play a role in the development of this condition, as some people may be more prone to degenerative disc disease due to their genetic makeup.
Lifestyle choices, such as smoking and being overweight, can also increase the risk of developing this condition.
Symptoms of Degenerative Disc Disease
- Back pain can be constant or sharp in the cervical, dorsal or lumbar region, which can radiate to the shoulder and arm (cervical) or to the legs and feet (lumbar).
- Numbness in the shoulder and arm: Numbness in the neck extends to the shoulder and arm.
- Muscle weakness in the cervical and dorsal region: difficulty performing movements, such as lifting objects, due to weakening the muscles in the lumbar region.
- Decreased sensitivity in the cervical region: tingling sensation or numbness in the cervical area, which is usually accompanied by a feeling of muscle weakness.
- Tingling in the cervical region: tingling sensation in the cervical region, which can radiate to the shoulder and arm.
- Rigidity in movements: difficulty in performing movements due to stiffness in the cervical region.
Causes for Numbness in the Arm
Cervical Disc Herniation
When a cervical disc rupture, forming a herniated disc, it can compress one or more nerves in the arm, causing pain and numbness.
If a cervical nerve root becomes inflamed or compressed, a person may experience radicular pain, tingling, numbness, and weakness in the shoulder, arm, and hand.
Mainly if a herniated disc occurs in the lower cervical spine, the symptoms will be pain in the scapula area with some numbness extending to the arm or hand.
Degenerative Disc Disease
Degenerative intervertebral disc disease is when the intervertebral disc between the vertebrae wears out over time, leading to a decrease in its height and strength. This condition is more common in older people and can cause back pain, stiffness, limited mobility, and even spinal deformities. Treatment includes pain medications, stretching exercises, physical therapies, and, in severe cases, surgery.
Foraminal Stenosis
When the intervertebral foramen narrows between adjacent vertebrae, we call this foraminal condition stenosis. In this case, a nerve root may become impinged as it exits the spinal canal.
Foraminal stenosis can be caused by bone spurs (osteophytes) or other degenerative processes in the spine. If the nerve root in the lower cervical spine becomes compressed or inflamed, it can cause pain, tingling, numbness, and/or weakness in the shoulder, arm, hand, and/or fingers.
Trauma to the Neck or Shoulder
Trauma to the neck or shoulder, such as during a sports collision or fall, can cause the brachial plexus (a group of nerves that runs through the shoulder and arm) to become overloaded.
The main symptom is a burning pain that starts in the neck or shoulder and travels down the arm. It may also be accompanied by numbness or weakness in the arm or hand.
Chest compression syndrome
Chest compression syndrome occurs when nerves or blood vessels become compressed in the area between your upper rib and collarbone.
This rare condition can cause pain, tingling, numbness or weakness anywhere from your neck and shoulder to your arm and hand. Therefore, someone with this condition can experience shoulder pain and arm numbness.
Performing aerial work can exacerbate shoulder pain and arm numbness/weakness. The arm and hand can also become more easily fatigued during routine activities.
Brachial neuritis
Brachial neuritis, also called Parsonage-Turner syndrome, develops when at least part of the brachial plexus (a group of nerves that runs through the shoulder and arm) becomes inflamed.
This condition usually has a sudden onset, unrelated to an injury. It can cause pain, tingling, numbness, and weakness anywhere along the nerve pathways in the neck, upper back, shoulder, arm, and hand.
Brachial neuritis usually lasts from a few hours to a few days. In rare cases, it can last much longer or become permanent.
Importance of Degenerative Disc Disease
In summary, the term “degenerative disc disease” is widely used in clinical and basic science disciplines, especially among spine surgeons, and is the most common rationale for lumbar spine fusion in the United States.
Definitions of the term vary widely, ranging from disc desiccation to specific symptomatic conditions, and there is no single definition used in the majority of publications.
Systematic differences are observed when referring to degenerative disc disease in the context of cervical versus lumbar regions, as well as between surgical and other disciplines.
Battié MC, Joshi AB, Gibbons LE. Degenerative disc disease: what is in a name?. Spine. 2019 Nov 1;44(21):1523-9.
Treatments for degenerative disc disease
There are various treatment options available for degenerative disc disease, depending on the severity of the condition.
In some cases, conservative treatment options may be effective, such as physical therapy, chiropractic care, and pain medication.
In more severe cases, surgery may be necessary to relieve pressure on the nerves and provide pain relief.
- Physical Therapy: Exercises and manual treatments can help relieve pain and improve disc function.
- Medications: Many times, non-steroidal anti-inflammatory drugs (NSAIDs) and pain relievers are prescribed to relieve pain and inflammation.
- Corticosteroid Injections: Corticosteroid injections are given at the site of injury to relieve pain and inflammation.
- Surgery: In more severe cases, surgery may be required to repair or replace the degenerated disc.
Physical Therapy for Degenerative Disc Disease Rehabilitation
Benefits of Physical Therapy for Degenerative Disc Disease Pain Rehabilitation
- Reduce Pain – Physical therapy can provide a number of interventions to reduce the pain caused by degenerative disc disease. This can include modalities such as heat, cold, electrical stimulation and ultrasound, which act to reduce inflammation and stimulate healing. Physical therapists may also use manual therapy techniques such as massage, stretching and joint mobilization to reduce pain and improve mobility.
- Improve Mobility – Physical therapy can help to improve range of motion and decrease stiffness in joints and muscles, allowing individuals to move more freely and complete activities of daily living with greater ease. This can be accomplished through the use of exercises such as stretching and strengthening, which help to improve flexibility and muscle strength.
- Enhance Core Stability – Core stability exercises are essential in the rehabilitation process of degenerative disc disease. These exercises involve strengthening the abdominal, pelvic and lower back muscles in order to support the spine and improve posture. Physical therapists can provide guidance and instruction on how to properly perform these exercises to ensure they are done safely and effectively.
- Improve Balance – Balance is an important aspect of physical therapy for degenerative disc disease. Physical therapists can provide balance retraining exercises to help individuals improve balance and decrease their risk of falls. These exercises can involve standing on one leg or walking on a balance beam, which can help to improve the coordination and stability of the body.
- Educate on Injury Prevention – Physical therapy can also provide education on injury prevention. Physical therapists can provide guidance on how to properly lift and carry objects, how to maintain proper posture, and how to prevent further injury to the spine. This education is essential in order to reduce the risk of further injury and promote long-term health.
Physical Therapy Modalities for Rehabilitation
Some options include:
- Transcutaneous Electrical Nerve Stimulation (TENS) – TENS is a type of electrical stimulation used to provide relief from pain. It involves the application of small pulses of electricity to the affected area, which can help reduce pain and improve muscle function. TENS is generally safe and is often used in conjunction with other modalities to provide relief from pain.
- Ultrasound – Ultrasound is a type of modality used to reduce inflammation, stimulate healing, and provide relief from pain. It involves the application of sound waves to the affected area, which act to increase circulation and reduce stiffness. Ultrasound can also help to improve range of motion and reduce muscle spasms.
- Myofascial Release – Myofascial release is a form of manual therapy that can help to reduce pain and improve mobility. It involves applying gentle pressure to the affected area in order to release tightness and improve flexibility in the muscles and connective tissue. Myofascial release can be used to treat a variety of conditions, including degenerative disc disease.
Frequently Asked Questions
Can degenerative disc disease cause shoulder and arm pain?
Yes, degenerative disc disease can cause shoulder and arm pain, as well as pain in other parts of the body.
How is degenerative disc disease diagnosed?
Diagnosis of degenerative disc disease usually involves a physical exam and medical history, followed by imaging tests such as X-rays, CT scans, or MRIs.
Can degenerative disc disease be prevented?
While it may not be possible to completely prevent degenerative disc disease, maintaining a healthy lifestyle, including regular exercise and not smoking, can help reduce the risk of developing this condition.
What are the risk factors for developing degenerative disc disease?
Risk factors for developing degenerative disc disease include aging, genetics, smoking, being overweight, and having a physically demanding job.
Is surgery always necessary to treat degenerative disc disease?
No, surgery is not always necessary to treat degenerative disc disease. In many cases, conservative treatment options may be effective in providing pain relief and improving function.
Conclusion
In conclusion, if you are experiencing shoulder and arm pain, it could be related to degenerative disc disease.
This condition can cause pain and other symptoms due to the degeneration of the spinal discs, which can put pressure on the nerves that run through the spinal column.
Treatment options vary depending on the severity of the condition, and may include conservative measures such as physical therapy and pain medication, or more invasive options such as surgery.
If you are experiencing symptoms of degenerative disc disease, it is important to speak with your healthcare provider to determine the best course of treatment for your individual needs.
M.D. Orthopaedic Pain Management - University of São Paulo
References
| ↑1 | Battié MC, Joshi AB, Gibbons LE. Degenerative disc disease: what is in a name?. Spine. 2019 Nov 1;44(21):1523-9. |
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| ↑2 | Hemanta D, Jiang XX, Feng ZZ, Chen ZX, Cao YW. Etiology for degenerative disc disease. Chinese Medical Sciences Journal. 2016 Sep 1;31(3):185-91 |
| ↑3 | Korinth MC. Treatment of cervical degenerative disc disease–current status and trends. Central European Neurosurgery-Zentralblatt für Neurochirurgie. 2008 Aug;69(03):113-24. |