Dr. Arnan Sisson, PT / November 23, 2022

What Causes Shoulder Pain Radiating Down Arm To Fingers?

There are three main sources of shoulder pain that radiates down your arm to your fingers.

1. The nerve roots in your neck
2. A bundle of nerves in your shoulder called the brachial plexus
3. The shoulder joint and rotator cuff muscles

Pinched Nerve In Neck With Pain Radiating Down To Your Fingers

The most common cause of shoulder pain that radiates down your arm to your fingers is from the nerve roots in your neck. In particular, the C6, C7, and C8 nerve roots the ones that go into your hand and fingers.

• C6 nerve root goes down to your thumb and index finger.
• C7 nerve root goes to the middle three fingers
• C8 nerve root goes to your little two fingers

(Note: There's no C8 vertebrae.  The C8 nerve root exits between the C7 and T1 vertebrae.)

Now for every person, there's going to be slight anatomical differences.

Everyone's wired a little bit differently, but in general it's the C6, C7, and C8 nerve roots that cause pain that radiates from your arm down to your fingers.

The C5 nerve root does radiate into your shoulder and into your upper arm, and sometimes even down to the wrist, but it doesn't usually go into the hand.

Brachial Plexus Injuries

The brachial plexus is a bundle of nerves that forms from the nerve roots in your neck: C5, C6, C7, C8, and T1

These nerve roots join together to form this big bundle of crossing nerves.

As you can see, the brachial plexus is pretty complex.

Those nerves run through the scalene muscles in your neck, then between the collar bone and first rib. Next they run under your chest muscles and then in front of your shoulder. The branches of the brachial plexus then run down your arm and into your fingers.

A brachial plexus injury or a compression of the brachial plexus (such as in thoracic outlet syndrome) can cause pain that radiates down the arm into the fingers.

The term thoracic outlet syndrome means that the brachial plexus is being pinched somewhere between the neck and the shoulder joint.

Shoulder Pain That Radiates Down Arm To Hand

The shoulder joint and the muscles around it can also be a source of pain that radiates down the arm.

Shoulder Instability

As mentioned above, the brachial plexus passes in front of the shoulder joint itself.

If you have an unstable shoulder that dislocates or pops out of socket, it can run into branches of the brachial plexus. This in turn can cause shoulder pain that radiates down the arm.

Rotator Cuff Referred Pain

A rotator cuff problem can also cause shoulder pain that radiates down the arm. It may be a tear. or it may just be some knots or trigger points in the rotator cuff muscles.

Many people think of the rotator cuff, or "rotary cup" as it's sometimes mistakenly called, as one thing. In reality though, the rotator cuff is actually made up of four different muscles.

Each of the 4 rotator cuff muscles has it's own pain referral pattern.

However, the supraspinatus and infraspinatus are the two muscles that radiate the farthest down into the arm and sometimes into the fingers.

Supraspinatus - refers into the outer arm and sometimes down to the wrist but rarely into the fingers

Infraspinatus - the muscle right on the back of your shoulder blade. It can refer all the way down the inside of your arm into your fingers.

What About Other Causes Of Shoulder Pain Radiating Down Your Arm?

f you're having left shoulder pain that radiates down your arm, make sure that you can rule out a heart attack!

Hear related shoulder-pain most commonly happens on the left side and comes on suddenly.

It may be associated with chest pain and shortness of breath and worsened with a general increase in activity level such a walking or climbing stairs.

If you're having any of those symptoms,  call 9-1-1 right away.

However, if the problem is less urgent, less severe, and has been going on awhile, chances are more likely that your shoulder pain radiating down the arm is from one of the other causes mentioned earlier.

Shoulder Pain Radiating Down Arm To Fingers Treatment

The best treatment for radiating shoulder pain really depends on what the source of the problem.  Namely, is it coming from your neck, your brachial plexus, or your shoulder?

How To Stop Shoulder And Arm Pain from A Pinched Nerve In Your Neck

Pinched nerves in the neck often occur when there's decreased space between the vertebrae and the openings where the nerves come out have gotten smaller.

Examples of conditions that can cause a pinched nerve in the neck include degenerative disc disease or degenerative joint disease (a.k.a. arthritis).  All of those can narrow the spaces around the nerve roots.

Again, most commonly the C6, C7, and C8 nerve roots are the ones that refer pain down in to the hand and fingers.

So how do you open the spaces around those nerve roots?

In general, you want to stretch your neck away from the side that's pinched.  That opens the spaces where the nerves come out and takes some pressure off of the nerve roots.

What about if the pain is coming from your brachial plexus?

If your shoulder and arm pain is coming from your brachial plexus, there are a lot of different things that may be at fault.

Addressing each of those causes individually is the best way to relieve brachial plexus problems such as thoracic outlet syndrome.

Some exercises to help brachial plexus problems include:

1. Scalene stretches / first rib mobilization
2. Chest stretches

Treatment For Shoulder And Rotator Cuff Problems

If your shoulder pain is truly coming from the shoulder, you still have to find out what type of problem that you're dealing with.

For example, is it an instability problem such as a labral tear?

Or do you just have stiff trigger points in your rotator cuff muscles that need to be stretched out?

Or do you have weak shoulder muscles that need strengthening exercises?

Our Shoulder/Neck Pain Guide can give you some general information about how to stop treat your shoulder pain.

However, if you've gotten to to the point where you have pain radiating down your arm into your hand, it's probably time to get help.

If you'd like to find out what's causing your shoulder and arm pain and how to get rid of it as quickly as possible, click the button below to request an appointment with one of our specialists.

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