When Shoulder Pain Travels

“This is 1 in my Top 5 Muscular Conditions series

If you’ve ever felt a burning pain around the shoulder blade or rotator cuff that travels down the back of the arm, sometimes with tingling in the fingers, you’re not alone. I see this presentation regularly in clinic here in West Sussex — especially in desk workers, side sleepers, and anyone who spends long hours reaching for a mouse or phone.

The surprise for many clients?

👉 It’s often not just a rotator cuff problem.

In many cases, the real culprits are:

• Tight pectoral muscles pulling the shoulder forward

• Poor posture narrowing key nerve spaces

• Irritation of the radial nerve as it passes through the triangular space

Let’s break this down in plain English (with just enough anatomy to be useful).

What Does This Pain Pattern Usually Feel Like?

Clients often describe:

• A burning or deep ache around the back of the shoulder

• Pain that travels down the back of the arm

• Tingling or “pins and needles” in the hand or fingers

• Symptoms that worsen:

  • When lying on the affected side

  • After long hours at a computer

  • With reaching, pulling, or overhead movements

❗ If that sounds familiar, read on — because simply “strengthening the rotator cuff”

often isn’t enough.

The Posture–Pectoral Tightness Connection

Modern life is not kind to shoulders.

Hours of sitting, scrolling, driving, and laptop work tend to place the shoulders in a rounded, forward-rolled position. Over time, this leads to:

• Shortened pectoralis major and minor

• Reduced thoracic extension

• Forward positioning of the humeral head

• Increased strain on the posterior shoulder muscles

The result?The shoulder becomes biomechanically crowded, and structures that don’t like being crowded — such as nerves — start to complain.

⚠️ Call-out: Tight Pec Muscles Don’t Just Affect the Front

Tight pectorals can contribute to posterior shoulder pain and nerve symptoms, not just chest tightness. This often surprises people.

The Triangular Space: A Small Area With Big Consequences

Behind the shoulder sits a lesser-known but clinically important area called the triangular space.

What passes through it?

• The radial nerve

• A key blood vessel (profunda brachii artery)

  
  

Why does this matter?

The radial nerve supplies:

• Sensation to the back of the arm and hand

• Motor control to the triceps and wrist extensors

  
  

When posture, muscle tension, or repetitive strain narrows this space, the nerve can become irritated — producing burning pain and tingling that radiates down the arm.

This is why some people feel symptoms that don’t behave like classic rotator cuff pain.

Why Side Sleeping and Desk Work Make It Worse

Two common aggravators I hear about daily in clinic:

🛏️ Side Sleeping

• Prolonged compression of the shoulder

• Arm often positioned overhead or across the body

• Reduced blood flow and nerve irritation overnight

  
  

🖱️ Computer & Mouse Use

• Sustained internal rotation of the shoulder

• Pec shortening

• Overactivity of the posterior shoulder stabilisers

• Gradual narrowing of nerve pathways

In other words: your shoulder never gets a break.

Is This the Same as a Rotator Cuff Injury?

Not always.

While rotator cuff tendinopathy can cause shoulder and upper arm pain, tingling into the fingers usually suggests nerve involvement.

That nerve irritation may be:

• Secondary to posture

• Related to pectoral tightness

• Occurring at the triangular space

• Or a combination of the above

This is why a proper assessment — not just a scan or exercise sheet — matters.

How Soft Tissue Massage Helps (And Why It’s Not “Just a Rub”)

As a myotherapist, soft tissue work is one of the most effective tools I use for this presentation.

Benefits of Soft Tissue Massage for This Condition

✔️ Reduces tone in tight pectoral muscles

✔️ Improves shoulder positioning

✔️ Decompresses irritated nerve pathways

✔️ Relieves trigger points referring pain down the arm

✔️ Improves circulation and tissue glide

✔️ Restores balance between anterior and posterior shoulder muscles

Targeted work often includes:

• Pectoralis major and minor

• Teres major and minor

• Posterior deltoid

• Long head of triceps

• Scapular stabilisers

  
  

⚠️ Call-out: Why Symptoms Often Improve Quickly

When nerve irritation is posture- or tension-driven, reducing compression can lead to rapid symptom relief — sometimes within a few sessions.

Recommended Exercises to Relieve Symptoms

These are general guidelines, not a substitute for individual assessment — but they’re a great starting point.

1. Pectoral Stretch (Doorway Stretch)

• Stand in a doorway

• Elbows at shoulder height

• Gently step through until you feel a stretch across the chest

• Hold 20–30 seconds

• Repeat 2–3 times

  
  

💡 Tip: No forcing — we’re lengthening tissue, not arm-wrestling the door frame.

2. Thoracic Extension (Seated or Foam Roller)

• Sit tall or lie over a foam roller

• Support your head and gently extend the upper back

• Focus on opening the chest

• 6–10 slow repetitions

This helps reverse the posture that started the problem in the first place.

3. Scapular Retraction Drill

• Stand or sit upright

• Gently draw shoulder blades back and down

• Hold for 5 seconds

• Repeat 8–10 times

This improves shoulder positioning without over-loading the rotator cuff.

4. Sleep Position Modification

Avoid:

❌ Lying directly on the painful shoulder

❌ Arm tucked underneath your body

❌ Arm overhead for long periods

Try:

✔️ Lying on the opposite side

✔️ A pillow supporting the affected arm in front

✔️ Neutral shoulder positioning

Sometimes this change alone reduces night pain dramatically.

What Not to Do (Common Mistakes)

🚫 Stretching aggressively into pain

🚫 Ignoring tingling or numbness

🚫 Only strengthening without addressing tight tissues

🚫 Assuming pain = damage

Pain is often about irritation and compression, not structural failure.

When to Seek Professional Help

If symptoms:

• Persist longer than 2–3 weeks

• Worsen at night

• Include increasing numbness or weakness

• Interfere with daily activities

…a hands-on assessment is strongly recommended.

In clinic, I assess:

• Posture and movement patterns

• Neural tension

• Soft tissue tone

• Shoulder mechanics

• Lifestyle contributors (workstation, sleep, training)

• 
  

Final Thoughts from a West Sussex Myotherapist

Burning shoulder pain that runs down the arm isn’t something to ignore — but it’s also very treatable when the right structures are addressed.

In many cases, the solution isn’t just “strengthen the rotator cuff”, but:

• Restore shoulder balance

• Release tight pectoral muscles

• Reduce nerve compression

• Improve posture and movement habits

Your shoulder isn’t broken — it’s just asking for a bit of mechanical common sense.