Pain in the shoulder and neck

Pain in the shoulder can be caused in the joint itself or by the soft tissue structures (for example, the tendons of the rotator cuff).

Shoulder pain usually increases with activities or movement of the arm.

Certain diseases and complaints in the chest and abdominal region (for example, the heart or gallbladder) can also cause pain in the shoulder.

Pain that originally comes from a different structure is called “transmission pain.”

This type of pain does not increase with the movement of the shoulder.


Causes of shoulder pain

The most common cause of shoulder pain is injuries to soft tissues, such as:

  • Brawn
  • Yearning
  • Annoy
  • Tapes.

These can occur as a result of whiplash or a fall.

Some active trigger points (pain points in the muscles) can cause pain in the neck or chest that radiates to the hand.

The myofascial pain is caused by small adhesions in the connective tissue (fascia). You can feel it from the neck to the shoulder.

Spondylosis (vertebral arthrosis) of the cervical spine can irritate the nerves of the arm plexus, which can cause:

  • Neck
  • shoulder pain,
  • arm pain,
  • Even hand pain.

Protrusion or a herniated disc in the cervical spine can cause neck pain that radiates into the arm (cervicobrachialgia).

However, the symptoms often do not correspond to the findings from instrumental examinations (for example, magnetic resonance imaging) (Lawrence – 1969).

In fact, there are people:

  1. With spondylosis and hernias that do not cause pain,
  2. With mild osteoarthritis or protrusion that cause severe pain.

So, magnetic resonance imaging is useful, but it must be interpreted correctly.

In addition, accurate diagnosis is required through the physical assessment of the doctor or physiotherapist.

Risk factors for shoulder and neck pain:

  1. Heavy physical activities, such as lifting heavy objects (Mayer – 2012)
  2. Computer work (Waersted – 2010),
  3. Incorrect posture (Palmer – 2007),
  4. Tendency to somatization (Hoe – 2012). One often speaks of somatization, but there are concrete parameters that indicate whether a person suffers from this problem. It is checked whether the patient has another 5 characteristic symptoms:
    1. fainting or dizziness,
    2. chest pain,
    3. nausea or stomach discomfort,
    4. Shortness of breath
    5. Cold or heat waves.

Symptoms and signs that occur along with shoulder pain

The pain can be described as:

  • Dull
  • Stabbing
  • Pulsating
  • Similar to a burning or spasm.

The assessment of each symptom is important for the doctor, because due to the type, the cause of the disorder can be understood.

Weakness: Weakness can be caused by severe pain caused by the movement of bones or muscles.

The muscle-innervating nerves can be irritated or injured.

You have to distinguish whether there is a real weakness (muscle or nerve lesions) or whether you avoid movement for fear of the pain.

Numbness: If the nerves are pinched, bruised or injured, sensitivity is impaired.

You can feel:

  • A burning,
  • tingling sensation,
  • The loss or impairment of sensation, as if the arm had “fallen asleep”.

Depending on the location of nerve irritation, pain may occur in the following places:

  • On the neck and in the front area of the arm,
  • In the back and posterior part of the upper limb up to the middle finger, in this case, pain may increase when coughing or deep inhalation,
  • In the armpit and on the inside of the arm.

Feeling cold: A feeling of cold in the hand or arm indicates that the arteries, veins, or both allow insufficient blood circulation. This may mean that not enough blood gets into the arm.

The arteries of the arm are controlled by the nerves of the sympathetic nervous system.

Therapy for shoulder and neck pain


The doctor may prescribe:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen (Brufen), and naproxen (Synflex). They can bring relief if the pain is caused by irritation or inflammation of the nerves.
  • Corticosteroids
  • A short-term oral cortisone cycle can relieve pain by reducing swelling and inflammation of the nerve.


If, after a few weeks or months, conservative treatment has not relieved symptoms, the doctor may advise surgical intervention, for example, in the case of a herniated disc.

4 effective solutions for shoulder and neck pain

The following indications are indicated if the pain occurs during movement. However, if it persists, then it is better to consult a doctor.

1) Home remedies:

  • Take a hot shower or a hot envelope
  • Stay active despite the pain,
  • Ask someone to massage the neck,
  • improve posture by using a roller for the lumbar spine,
  • Use ergonomic aids when working at the computer,
  • Only with a single pillow
  • On a hard mattress Rarely, the mattress is the cause of the pain. Therefore, we do not necessarily recommend changing the mattress even for neck pain.

2) Exercises

There are some very effective exercises according to McKenzie against these ailments.

It is important to perform these exercises only if they do not cause pain. Minor complaints can be tolerated.

For one minute, the symptoms may persist after the exercises, but they must not remain.

Retraction and neck stretching

  • Sit down
  • Pull back the chin and keep the neck straight,
  • In this position, stretch the neck (as if looking up),
  • return to the starting position,
  • Repeat 10 times.

Retraction and lateral tilt

  • Starting position: sitting,
  • pull chin backwards, the cervical spine is stretched,
  • From this position, tilt the neck sideways, only to one side,
  • return to the starting position,
  • Repeat 10 times.

First of all, one should find out which exercise leads to a better result (pain relief or improvement of mobility).

After that, you should do the better-working exercise about every 2 hours.

4) Manual therapy

The most effective manual therapy in this case is the treatment of active trigger points.

Many patients are surprised when the physiotherapist treats areas of the non-painful body. In fact, this is normal, because often the pain arises in other areas of the body.

In particular, the muscles that can cause pain radiating from the neck to the arm are:

  1. scalenus muscles (front of the neck),
  2. Small pectoral muscle (outer part of the chest),
  3. Subclavius muscle (under the collarbone).

During treatment, the patient lies with relaxed (not stretched) muscles.

The treatment consists of a steady pressure that is maintained for about 90 seconds or until the trigger point is deactivated.

5) What to avoid?

  • Do not wear a support collar, this can only increase the rigidity,
  • Do not put ice on your neck,
  • Do not stretch, because the pain increases as a result.

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