If you have been dealing with stubborn shoulder pain that flares up when you reach overhead, sleep on your side, or move your arm across your body, the cause might be deeper than you think. Watch the video below to see how we tackle shoulder impingement and spinal accessory nerve entrapment right here at our office.
What Is Shoulder Impingement?
Shoulder impingement happens when the tendons or bursa in your shoulder get pinched between the bones of the joint, most often the rotator cuff tendons and the acromion bone above them. It is one of the most common causes of shoulder pain we see in the office, and it can affect desk workers, athletes, and everyone in between.
The frustrating part is that it often develops gradually. You might notice mild soreness at first, then over time that soreness turns into sharp pain that limits what you can do.
What Is Spinal Accessory Nerve Entrapment?
This is a piece of the puzzle that gets overlooked a lot. The spinal accessory nerve (cranial nerve XI) controls two major muscles: the trapezius and the sternocleidomastoid. When this nerve gets compressed or restricted, it can cause shoulder pain and weakness that looks and feels just like classic impingement.
If you have tried treatment before and your shoulder still is not improving, nerve involvement could be exactly why.
Symptoms to Watch For
- Pain when lifting your arm overhead or out to the side
- Deep aching in the shoulder, especially at night
- Weakness when reaching, pushing, or carrying
- A clicking, catching, or grinding sensation in the joint
- Tightness or stiffness running from the neck into the shoulder blade
- Pain that gets worse with certain positions and better with rest, then comes back
Common Causes
These conditions rarely come from one single thing. Here are the factors we see most often:
- Forward head posture and rounded shoulders that change how the joint loads
- Repetitive overhead movement at work or in sports
- Tight muscles in the chest, neck, and upper back pulling the shoulder blade out of position
- Restricted joints in the cervical or thoracic spine
- Old injuries that were not fully rehabilitated
- Muscle imbalances that affect scapular movement and shoulder mechanics
Treatment Approach: Chiropractic Adjustments
When joints in the neck or mid-back are not moving the way they should, the shoulder has to compensate. Over time that compensation leads to impingement and pain. Chiropractic adjustments restore proper motion to those restricted joints so the entire shoulder complex can work as a unit instead of fighting itself.
We also look at shoulder girdle mechanics directly, not just the spine, because the two are closely connected.
Treatment Approach: Active Release Technique (ART)
Dr. Jordan Warner specializes in Active Release Technique, a hands-on soft tissue method designed to break up scar tissue and adhesions that restrict how muscles, tendons, and nerves move against each other.
For spinal accessory nerve entrapment in particular, ART is one of the most effective tools available. Here is why:
- It targets the exact tissue trapping the nerve, not just the area that hurts
- It restores normal tissue glide so the nerve can move freely during shoulder motion
- It reduces pain and stiffness faster than passive rest alone
- It works well alongside adjustments because both address different layers of the same problem
Treatment Approach: Dry Needling
Dry needling is one of my favorite tools for shoulder cases because trigger points in the upper traps, rotator cuff, and surrounding muscles can directly contribute to impingement by pulling the shoulder out of alignment and restricting movement.
What dry needling does for shoulder pain:
- Releases tight trigger points that are altering shoulder mechanics
- Reduces localized inflammation and pain
- Improves range of motion, often within the same session
- Prepares the tissue to respond better to adjustments and ART
Why We Combine All Three
Shoulder impingement and nerve entrapment almost always involve joint dysfunction, restricted soft tissue, and muscle imbalance happening at the same time. Treating just one layer often leaves the others unaddressed, which is why pain keeps coming back. By combining chiropractic adjustments, Active Release Technique, and dry needling, we are working on all three levels simultaneously so the improvement actually holds.
Come See Us in Leland
If you are in Leland, Wilmington, or anywhere in Brunswick County and your shoulder pain is getting in the way of daily life, we would love to help. Call us at (910) 859-8359