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Problems with the neck, shoulder and arm are often called different things by patients: neuritis; bursitis; neuralgia; rheumatism; frozen shoulder; fibrositis; sprained, strained or sore muscles, or “poor circulation.” Some people may blame their shoulder (or other joint) problems on “old age” even though their other shoulder, which doesn’t have any problems, is just as old.

The brain “talks” with the rest of your body through a vast telecommunications system made up of nerves. Nerves come out of your brain in a large bundle called the spinal cord and travel down your back inside the spinal column.

As the nerves from your brain travel down your spinal cord, they first have to pass through holes (foramina) between the spinal bones (vertebrae). Some nerves go straight to their point of destination, but some first mix with other nerves to form complicated nerve networks that anatomists call a nerve plexus.

The brachial plexus is made up of nerves which come out of the middle and lower neck and upper back. After they interconnect to form the brachial plexus, they branch off to supply different areas, especially the shoulder, arms, elbows, wrists, hands, and fingers. The most common form of brachial plexus damage is to the nerves that make up the brachial plexus as they exit the spinal column through the foramina plexus. In the foramina, the nerves are surrounded by a ring of bone and meninges (tough coverings), and if the ring becomes smaller, the nerves may become compressed or “pinched.” What causes the nerves to get “pinched?" Many things: long-standing spinal stress; old injuries such as falls from childhood; new injuries such as sports mishaps or car accidents (especially whiplash - a situation where the head and neck are suddenly “snapped” forward and backward); arthritis; being twisted, pulled or shaken; or even sleeping in an awkward position as well as many other stresses and strains of daily living. The right brain controls the left side of the body, and the left brain controls the right side of the body. If the patient is experiencing pain on one side of the body (right or left), the opposite brain may be firing at an abnormally high rate. In order for a patient to perceive pain, an area of the brain must fire at a higher frequency of firing. If the pain is bilateral, or on both sides, there may be different central structures involved such as the brainstem or cerebellum.

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