One Simple Test To Identify Neck Sciatica

One Simple Test To Identify Neck Sciatica

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Shoulder pain or neck pain? How do you avoid the wrong diagnosis and get the right treatment?

Missing the diagnosis

I frequently see patients who had extensive treatment for neck or shoulder pain without relief. This is often due to the doctor or therapist missing the cause of the pain and treating the wrong body part.

The patient comes to me and says they have shoulder pain. They put their hand on top of the shoulder near the neck. “It hurts here”, they say. Sometimes they reach down to the inside of their shoulder blade and say, “right here where I can’t quite reach”.

They have shoulder x-rays, physical therapy, injections, medication and/or chiropractic treatment to relieve their pain. None of the treatments have worked.

The common diagnosis is muscle spasm. We are taught that muscle is causing the pain. This is not true because joints rule and muscles only adapt. Muscle spasm is your body’s attempt to protect the joint, disc, nerve, and you, from experiencing more pain. It spasms, protecting you from moving the more seriously damaged parts underneath.

Neck Sciatica

In many cases the patient is suffering from pain originating higher up in the neck. A nerve is pinched there, radiating pain into the shoulder, upper back and frequently the arm. I call it neck sciatica.

Think of a patient with a low back disc herniation pinching a nerve. They have leg pain. The doctor does not treat the leg, they treat the back. This is the same scenario for a nerve pinch in the neck. It radiates pain into the shoulder. The pain is coming from the neck.

One Simple test to get the correct diagnosis

If you have pain in your shoulder or upper back, there is one simple test to determine if the pain is coming from your neck. I wish all doctors knew this test. It could save a lot of patients from suffering, although make me less busy. I will accept the tradeoff.

The Test for neck sciatica

WARNING: Be careful, if there is a pinched nerve in your neck causing your symptoms, it will hurt a lot. Do it slowly. Stop when it hurts.

Part 1. Turn your head to the side of shoulder pain. If this hurts more, stop. If the neck rotation made your shoulder hurt, it is positive for neck sciatica. If you only have pain localized to your neck, that may be other joint or muscle issues. If you rotate all the way and it does not hurt, proceed to Part 2.

Part 2. With your head turned all the way to the side of pain, tilt your head backward like you are looking at the ceiling.

Outcome: If either Part 1, or Part 2 make your shoulder pain worse, you have a pinched nerve in your neck. You have neck sciatica.

How to take care of your pain at home:

  1. Ice – Place a wet cloth between you and the ice pack. Ice the middle of the neck from the hairline down to the first bump in your upper back. This is where the problem begins. It does not help to ice the site of pain. Ice for 15 minutes and repeat three times daily. {Icing Instructions in St Charles - Fox Valley Chiropractic Physicians (drglesener.com)}
  2. Medication – See our website link for the best use of over-the-counter medication. {Icing Instructions in St Charles - Fox Valley Chiropractic Physicians (drglesener.com)}
  3. Gentle ROM exercise – The area needs blood flow to heal the joint/disc, nerve, and muscle. Keep within tolerable limits of discomfort, and slowly move your neck in three ranges of motion: forward/backward, side to side, left and right rotation. Do each motion six times in a row. Repeat frequently throughout the day.

Seek professional help if home care does not help

  1. Chiropractic care with targeted exercises. We specialize in the Rapid Recovery Difference. A set of procedures and techniques which regularly resolves conditions like neck sciatica in seven sessions.
  2. Imaging – An x-ray can show the amount of age and previous damage to your neck, which predisposed you to this pain. If the condition does not improve in several weeks of care, or the arm pain comes with weakness, an MRI is needed. Even with disc herniation and advanced arthritic spurring in the neck, our program frequently provides relief and prevents surgery.
  3. Medication – I wished prescription medications worked well for this condition. They do not. New research points out the failure of muscle relaxers to provide relief {Icing Instructions in St Charles - Fox Valley Chiropractic Physicians (drglesener.com)and opioids are addictive. Prescription anti-inflammatories work minimally better than over-the-counter medications.
  4. Injections – The rare exceptions that do not respond to our conservative care are referred for aggressive medical intervention involving steroid injections, epidural injections and/or nerve ablation. The success rate for these procedures is poor. Most patients who do not respond to conservative care go from these procedures to surgery.
  5. Surgery – This is rarely necessary. Pain is not a surgical indication. If the nerve is pinched badly enough to cause arm or hand weakness, surgical decompression is required.

We always provide a free consultation for neck sciatica, or any other muscle, joint or nerve condition you are experiencing. If you are not a candidate for our Rapid Recovery Difference program, I will refer you to the right specialist.

Be Well,

Dr. Mark

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4:00pm - 6:00pm


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3:00pm - 6:00pm


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Fox Valley Chiropractic Physicians
1750 East Main Street Suite 60
St Charles, IL 60174
(630) 377-8844