When Shoulder Weakness Has No Pain – How the Upper Neck May Be Involved

by Son’s Rehabilitation Medicine & Chiropractic Clinic in Seoul

Sometimes, patients experience weakness in the shoulder or arm without any accompanying pain. In such cases, the issue may not be solely due to a herniated disc or peripheral nerve problem. Rather, it can be related to subtle misalignments in the upper cervical spine, particularly at C1 and C2.

These upper neck bones play a central role in connecting the head, brainstem, spinal cord, and the rest of the nervous system. When this delicate area is misaligned, it can create persistent tension within the spinal cord and its protective lining, known as the dura mater.

🧠 What Is "Tethering Tension" in the Upper Cervical Spine?

The term “tethering tension” refers to a state where the spinal cord and surrounding membranes are pulled or restricted due to mechanical imbalance, often originating from misalignment at C1–C2. This can prevent the spinal cord and nerves from moving freely, creating ongoing tension and interfering with nerve function.

Anatomically, the dura mater (the outer membrane covering the brain and spinal cord) is firmly attached near the base of the skull and the upper cervical vertebrae.
When this region is misaligned, it may transmit mechanical tension along the spinal cord, leading to symptoms not only in the neck but throughout the body.

🔗 How This Affects the Rest of the Body

This abnormal tension can affect many parts of the nervous system and musculoskeletal function:

Affected AreaPossible Symptoms
Shoulder/ArmWeakness, heaviness, motor control issues
Neck/HeadHeadaches, poor focus, dizziness
Whole BodyChronic fatigue, postural imbalance
Autonomic SystemPoor sleep, digestive issues, cold hands/feet

✅ A Case from Our Clinic

A woman in her 60s visited our clinic with weakness in her right shoulder, but she did not report any pain or numbness. MRI showed mild disc protrusion and ligament thickening in her mid-neck region, but these findings alone did not fully explain her symptoms.

Upon closer examination, we found a subtle misalignment in her upper cervical spine (C1–C2). After just three sessions of upper cervical-focused manual treatment, her shoulder strength improved significantly—from grade 3 to grade 4 in muscle testing.
Her ability to lift her arm returned closer to normal, and she felt much more confident using her arm in daily activities.

This case suggests that even without pain, symptoms like weakness or fatigue may stem from tethering tension in the spinal cord, related to upper neck dysfunction.

📚 Theoretical and Scientific Background

While "tethering tension" is not a formal diagnostic term in conventional medicine, studies in functional neurology, osteopathy, and biomechanics have explored how upper cervical misalignment may:

  • Disrupt normal spinal cord mobility

  • Increase mechanical tension within the dura mater

  • Affect circulation and nerve conduction

International literature has also described how upper cervical imbalance may influence whole-body symptoms, even in the absence of local pain.

🧘 Care at Son Rehabilitation Medicine & Chiropractic Clinic

We provide individualized assessment and non-surgical treatment for neck alignment and nervous system balance.
If you are experiencing symptoms such as arm weakness, unexplained fatigue, or dizziness—even without pain—it may be helpful to evaluate your upper cervical spine alignment.

This article is for general educational purposes only. For diagnosis and treatment of specific medical conditions, please consult a qualified physician.

 👍Consultation and Appointment Information

Son PMR & Chiropractic Clinic( 2nd floor, 229-1 Gucheonmyun-Ro, Gangdongu, Seoul, South Korea) 

by  Dr Son MD & DC 
Contact: 02-482-8875 in Seoul( +82-2-482-8875)

chson@daum.net

 

 


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