Shoulder pain can present as a result of a cervical spine disc disease, particularly when there is disc herniation in the lower cervical spine.
This might involve the facet joints, the intervertebral discs or a combination of degenerative changes in all of these structures. This can lead to a herniated disc in the neck. Certain congenital malformations can predispose the patient to develop more serious degenerative changes.
For instance, with spondylolisthesis there is some overriding of one vertebral body over another, and this is such a condition where severe degenerative changes in the adjacent facet joints can occur coupled with severe narrowing of the disc space from underlying degenerative disc disease. Spondylolisthesis (thanks to www.hughston.com for this link) can also develop from repetitive trauma, particularly in adolescents and young active adults as this link shows and this can lead to spondylolysis, an acute surgical emergency.This in turn can lead to a narrowing of the spinal canal (spinal stenosis),which can cause a pinched nerve with severe pain. These cases need a careful work-up by a neurosurgeon as some may need invasive neurosurgery, but others do best when left alone.
CT scans, MRI scans, myelography studies and bone scans are some of the diagnostic procedures that might have to be ordered. Symptoms of pain and weakness in the shoulder are only one part of a symptoms complex.
Cervical Spine Disc Disease
Other symptoms are neck stiffness and neck pain as well as loss of feeling in some or all fingers as well as weakness in the arm muscles. The patients who will need surgery might need discectomy and a cervical laminectomy. Part of the bone is removed to give the nerve root more breathing space. In other cases cervical fusion may be necessary.
References:
1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999.
2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999.
3. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders
4. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
5. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
6. Wheeless’ Textbook of Orthopaedics:http://www.wheelessonline.com/ortho/arthritis Several topics can be found under this link by entering the term you search for.
7. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008
