Understanding Neck and Shoulder Pain

Neck and shoulder pain commonly occur together. This combination of pain can be particularly challenging because both the neck and shoulder may have reduced motion, which can affect many more routine activities compared to when just the neck or shoulder is involved.

What Does Neck and Shoulder Pain Feel Like?

Neck and shoulder pain may start suddenly, such as after an injury, or gradually. Many people with neck and shoulder pain experience one or more of the following:

• Mild discomfort or achiness, which may feel localized to a spot between the neck and shoulder or diffused across a broader region across the shoulder and/or up the neck
• Sharp or shock-like pain that likely comes and goes, possibly radiating down the shoulder and/or into the arm or hand
• Stiffness and decreased range of motion in the neck and shoulder, which may limit the ability to turn the head or lift the arm
• Tenderness in the neck or shoulders that worsens when pressed (these spots of tenderness are sometimes called trigger points)
• Tingling, numbness, and/or weakness that can go down into the shoulder, arm, and/or hand

  Watch Cervical Radiculopathy Interactive Video

In some cases, the neck and shoulder pain may worsen with certain activities, such as turning the head to the side, working above the head, or participating in sports. For others, the pain may worsen when resting, such as when sitting or trying to sleep.

Development of Neck and Shoulder Pain

The neck and shoulder are interconnected by many nerves, blood vessels, muscles, and other tissues. A problem in the neck can send pain to the shoulder, and vice versa. Some of the underlying biomechanics that can contribute to both neck and shoulder pain include:

• Muscle dysfunction. An injury or inflammation to a muscle in the neck or shoulder may lead to pain and stiffness. Sometimes when one muscle becomes tight or dysfunctional, nearby muscles may need to work more and become painful. The muscles’ connective tissues (fascia), tendons, or ligaments may also become injured or inflamed, possibly sending referred pain to nearby areas.

See Neck Strain: Causes and Remedies

• Nerve compression or inflammation. When a nerve in the neck becomes compressed or inflamed, it may send pain down into the shoulder, arm, and/or hand. Similarly, a nerve compressed or inflamed in the shoulder may radiate pain up to the neck.¹Arthritis of the Shoulder. American Academy of Orthopaedic Surgeons website. http://orthoinfo.aaos.org/topic.cfm?topic=a00222. Last reviewed: January 2013. Accessed August 8, 2019. The brachial plexus, which is the group of nerves that run from the lower neck and upper back across the shoulder, can be involved in various types of neck and shoulder pain.

  See Cervical Radiculopathy Symptoms

• Blood vessel compression. If blood vessels between the neck and shoulder become compressed, it may affect blood circulation and cause pain or swelling.

Many other factors may be involved with developing neck and shoulder pain, such as stress or anxiety.²Buscemi V, Chan W-J, Liston M, McAuley JH, Schabrun SM. The role of perceived stress and life stressors in the development of chronic musculoskeletal pain disorders: a systemic review. J Pain. 2019. doi: https://doi.org/10.1016/j.jpain.2019.02.008 Sometimes neck and shoulder pain may have more than one cause or separate causes.

Getting a Diagnosis for Neck and Shoulder Pain

Seek a medical evaluation for neck and shoulder pain if any of the following are true:

• Pain persists for a couple weeks
• Pain interferes with daily activities
• Numbness or weakness are present

Only a trained medical professional can give an accurate diagnosis. Once an accurate diagnosis is reached for the specific cause of neck and shoulder pain, an effective treatment plan can be started.

See Diagnosing Neck Pain