Given the close anatomical proximity between the neck and shoulder, it is not surprising that the two body parts are intimately related.
During a hectic and chaotic day that could involve long drives, hunching over, or talking on the phone for hours, the muscles in the neck, upper back, and shoulders tend to ache and tighten up at the same time.
Neck and Shoulder Pain Relationship
In a recent study, researchers analyzed the relationship between the sitting posture of adolescents and shoulder and neck pain.
To examine the relationship, researchers analyzed the habitual sitting posture of 1,593 14-year-old adolescents with and without prolonged shoulder and neck pain by issuing each participant a questionnaire.
They discovered that prolonged shoulder and neck pain was reported by 5.3% of the adolescents; females reported a higher rate (6.5%) than the males (4.2%). They also found that females were more prone to sitting erect than the males were.
This raises the question: is there a direct connection between neck and shoulder pain? To properly understand the direct relationship between the two body parts, let’s first look at how the neck and shoulders work.
- Neck: The neck signals the nerves that relay to the head, shoulders, and arms. There are eight sets of nerves in the neck, 12 sets in the thoracic, which is the middle-back region, and five sets in the sacrum. All of these nerves allow us to move our muscles in any direction, as well as give us the ability to feel/experience various senses. If these nerves get pinched or irritated, they may lose their ability to function. This could make it very challenging to conduct everyday activities, such as picking up small objects, buttoning up a shirt, or even squeezing a spray bottle.
- Shoulder: When the shoulder is injured (i.e. a rotator cuff tear), the pain begins at the nerve endings—these are located in the area of the shoulder injury. It then transmits impulses between the shoulder and neck and then from the neck to the sensory cortex of the brain. The information is processed and the communication signaled to the motor cortex of the brain triggers nerve signals to be sent to the shoulder, which travels through the neck to the injured area of the shoulder. As a result, a reflex muscle spasm may occur as the spasm is trying to protect the injured shoulder.
Another reason why both areas tend to become injured at the same time is because we change the way we go about our daily activities and responsibilities and modify our functions. For example, if you have injured your shoulder and you are trying to put on a coat, you lean over to the opposite side every time. These types of changes can trigger a spasm in the neck.
Neck and Shoulder Pain Causes
- Cervical degenerative disc disease: This is one of the more common causes of neck pain, and is often compared to the feeling of a stiff neck. Stiffness and small amounts of pain are symptoms of cervical degenerative disc disease. Many patients also experience numbness, tingling, and weakness in the neck, arms, and shoulders, because the nerves in the cervical area have become pinched or irritated. To diagnose cervical degenerative disc disease, your physician will perform a physical examination to measure the neck’s flexibility. Your doctor may even request an X-ray, MRI, and/or even a CT scan—these diagnostic images will confirm if and where the degeneration is occurring.
- Whiplash: An injury to the neck as a result from a sudden jerking motion, either forward or backward, is called whiplash. In most cases, this type of injury occurs as a result of a rear-end motor vehicle accident. This type of injury can stretch the neck and upper back region and result in a strain or tear of the ligaments, muscles, or even discs, which can irritate the nerves. Early symptoms of whiplash are severe pain, stiffness, dizziness, and headaches. The recovery time for this injury depends on the person and how severe the injury is.
- Wry neck: This occurs when the neck suddenly becomes stiff or painful. Turning your neck to one side more than the other for a long period of time can cause acute pain. You may get spasms in one, or even both sides of the neck; the pain may be felt all the way from the top of the neck down to the shoulder area.
- Poor posture: People with poor posture can experience neck pain because extra strain is put on the ligaments and muscles. Common postural issues that will affect the neck directly include slouching your shoulders while standing, poking your chin forward, working with your head down for long periods of time, slouching when sitting, and sleeping face-down.
- Osteoarthritis: Neck and shoulder pain is not always caused by a quick movement or an injury; osteoarthritis is another cause of shoulder and neck pain. It is the most common type of arthritis and is caused by the altered usage of the joints over a long period of time. This occurs when there is a breakdown of cartilage—the firm cushion that is found between two bones—to prevent them from rubbing against each other.
Shoulder pain is typically a direct result from injuries. Common shoulder injuries include:
- Pinched nerves
- Frozen shoulder
- Acute or degenerative tendon problems
- Collar or upper arm bone fractures
Neck: The Culprit
If a person experiences inflammation in any of the nerves of joints in the neck, it can cause neck pain. Research indicates that about 70% of 65-year-olds may have symptomatic arthritis in one or more of the neck joints.
You may have arthritis or nerve-related neck pain if you experience any of the following:
- The pain persists when resting.
- The pain is felt down your arm and when you extend or twist your neck.
- The pain is felt past your elbow to your hand.
- The pain feels like stabbing, burning, or tingling.
Ways to Relieve Shoulder and Neck Pain
1. Physical therapy exercises: Performing proper stretches and simple weight exercises will not only strengthen the shoulder and neck muscles, but will also speed up the healing process if there is a torn or strained cartilage.
2. Resting from activities that aggravate pain: Avoid playing sports that aggravate the injury.
3. Ice/heating pad: Apply ice to the injured area to reduce the swelling or a heating pad to relax muscles.
4. Cortisone injections: These injections (conducted by a trained physician) can help reduce the inflammation in the shoulder.
“Is your shoulder pain actually a neck problem?” Cleveland Clinic web site; June 23, 2015; http://health.clevelandclinic.org/2015/06/is-your-shoulder-pain-actually-caused-by-a-neck-problem/.
Funk, L., “Neck Pain referred to the Shoulder,” ShoulderDoc.co.uk; https://www.shoulderdoc.co.uk/article/1529, last accessed August 14, 2015.
“Neck and shoulder pain,” Better Health Channel web site; http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Neck_and_shoulder_pain, last accessed August 12, 2015.
“The neck and shoulder pain relationship,” Advanced Wellness web site; http://www.advanced-wellness.net/blog/the-neck-shoulder-pain-relationship/, last accessed August 14, 2015.
Straker, L.M., et al., “Relationships between prolonged neck/shoulder pain and sitting spinal posture in male and female adolescents,” Manual Therapy 2009; 14(3):321-9.
“Cervical Degenerative Disc Disease,” Spine-health web site; http://www.spine-health.com/conditions/degenerative-disc-disease/cervical-degenerative-disc-disease, last accessed August 14, 2015.