What could cause severe shoulder pain that goes into the fingers?

A fellow caregiver asked...

My mother gets a severe pain down her right shoulder to her fingers. She has had several cortisone shots in her bursa in the shoulder and they have not worked. She is wondering if the pain, which is worse at night, could be coming from a disc in her neck. She has severe numbness and tingling in her right hand fingers at night. Her doctor has told her to have a shoulder operation, then told her it is carpel tunnel and to get her hand operated on, and then that it could just be arthritis. What test should she have to check exactly what it is. Should it be an x-ray of the neck discs, the hand, or the shoulder or somewhere else. Please can you give us a starting point, we are at our wits end with the pain she is in. Also should she be asking a neurologist or an orthopedic specialist. Thanks for the help, it is much appreciated. Sandra

Expert Answer

Jennifer Serafin, N.P. is a registered nurse and geriatric nurse practitioner at the Jewish Homes for the Aged in San Francisco.

Your mother sounds like she has a problem called radiculopathy. This is caused by a nerve that is being compressed somewhere in her body. If the pain starts in her shoulder, and goes all the way down to her hands, then I would think that her neck or her shoulder could be her problem. But, to complicate matters, she may have carpal tunnel too, as her hand symptoms sound quite severe.

If this was my patient, I would get xrays of the cervical spine as well as the affected shoulder. This would at least let me know if she has arthritis or some other kind of problem that would cause these symptoms. It may also help for her to see an orthopedist, as they may be able to pinpoint where her pain is coming from. The orthopedist may need to get an MRI of the neck or shoulder to find out in greater detail what is causing the problem so that a treatment plan can be implemented.

One other thought that went through my mind when I read this letter is that Physical Therapy may help your mother. They often can help reduce pain with gentle exercises, and they may offer more insight on what may be causing your mother's pain. Please ask your mother's primary care provider for a referral. Good luck!