I have been treating a client for the past 2 weeks who came to me be complaining of left shoulder pain. It all started two weeks ago when she lifted a heavy bucket off a table. The client reported that the pain got worse towards the end of the day and was aggravated when she lies on her shoulder. She was also saying the pain was referring into her first 3 fingers in the form of pins and needles and some numbness. The pain was not improving with rest….

On examination she had pain on moving her shoulder and when she flexed, side bent and rotated her neck to the left.  She also had very tight muscles in her neck, among other positive tests which were all consistent with a neck injury.

In particular her Scalene muscle was very tight and when i pressed on it it caused the same referral pain into her fingers. The Scalene muscles are located in the neck and attaches to the ribs, they assists with breathing and side bending the Neck. As per the image below, evidence shows that tight scalene muscles can refer pain down the arm to the fingers.

My initial treatment involved soft tissue massage to the neck and shoulder muscles, some gentle mobilisation to the neck and shoulder region. I also used Dry Needling on the upper traps and to the scalene muscle, this was all supported with Kinesio taping to the shoulder to help improve posture. I also prescribed some exercises to help improve her posture and strengthen the scalene muscle.

On her 2^nd appointment she reported just slight numbness in her index finger, she could now lie on the shoulder and movement was pain free.

I repeated a similar treatment and gave some progressive exercises… She cancelled her 3^rd appointment as her symptoms had resolved fully.