Neck and Shoulder Pain

The most common cause of shoulder pain and neck pain is injury to the soft tissues, including the muscles, tendons, and ligaments that surrounded the shoulder and neck.

Shoulder and neck pain can result from whiplash or other soft tissue injuries to these areas. Degenerative arthritis of the spine in the neck (cervical spine) can pinch nerves that can cause both neck pain and shoulder pain.

Degenerative disc disease in the neck (cervical spondylosis – spondylosis is a term referring to degenerative osteoarthritis of the joints, when present in the cervical area between the spinal vertebrae it is known as cervical spondylosis. This is caused by the space between two adjacent vertebrae narrowing and causing compression of a nerve root emerging from the spinal cord may result in severe pain in the neck, shoulder, arm, back, and/or leg, accompanied by muscle weakness) can cause local neck pain or radiating pain from disc herniation, causing pinching of nerves (cervical radiculopathy).

Abnormal conditions involving the spinal cord, heart, lungs, and some abdominal organs also can cause neck and shoulder pain. Examples are:

• Falling on your outstretched arm is one of the leading causes of a collarbone to break. This is particularly common when cyclists fall off of their bicycles.
• Bursitis is caused when the bursa sac that is over the joints to protect them and acts as a cushion to the joints and muscles become swollen, stiff, and painful after injuries.
• Myocardial infarction (MI) or commonly known as a heart attack cause shoulder or neck pain that is referred pain.
• An injury to the shoulder blade usually is associated with relatively powerful shock or blow that may result in a fracture of the shoulder blade.
• The rotator cuff is a group of tendons that support the shoulder. These tendons can be injured during lifting, when playing sports with a lot of throwing, falls, or after repeat use over an extensive time frame. This can lead to pain with motion of the shoulder due to shoulder impingement syndrome and eventually to a chronic loss of range of motion of the shoulder which is called frozen shoulder.
• Shoulder or A-C separation: The collarbone (clavicle) and shoulder blade (scapula) are connected by ligaments. With blunt force trauma – a hard hit to the shoulder, these ligaments can be stretched or torn.
• Injury to the ligaments and muscular structures of the neck and shoulder can be caused by sudden acceleration or deceleration. A “whiplash” injury is not uncommon, as many have experienced in car accidents. This type of injury can cause muscle spasms in the neck and shoulder areas.
• When the tendons that connect the muscles to the bones become strained or inflamed. The resulting strain results in the tendons becoming swollen and causing pain. This is called tendinitis.
• Pain in the right shoulder can be referred pain from gallbladder disease.
• Any cause of inflammation in the chest wall can also cause referred pain in the shoulder.

• Pain can lead to a stiff neck or shoulder along with a limited range of motion.
• Weakness can result from severe pain as you attempt to move the neck or shoulder muscles. The nerves that serve the muscle groups in the neck and shoulder areas can also be injured. It is important to distinguish true weakness (muscle or nerve damage) and the inability or reluctance to move because of pain and/or swelling.
• If the nerves are pinched, bruised, or cut, you may not be able to feel things as you normally would. Pinched, bruised or cut nerves can cause a burning or tingling sensation, a loss of feeling, or a sensation similar to having your arm “fall asleep.”
• An arm or hand that is cool or cold to the touch may suggest that the arteries, veins, or both have been injured or blocked by a clot. This may mean that not enough blood is getting into the arm and you need to seek Emergency Medical Treatment.
• A blue or white color shade to the skin of your arm or shoulder is another sign that blood vessels may have been injured. Redness can indicate infection or inflammation.
• Bruising may be apparent. Bruises tend to be reddish-purplish in color and develop when small blood vessels under the skin tear or break, usually from a bump or fall. Blood leaks into tissues under the skin and cause the black-and-blue color.
• Swelling to the whole arm or restricted over the injured area (an inflamed bursa sac over the shoulder joint, for example). Muscle spasms or tightness may simulate actual swelling.
• Dislocation can cause a swollen appearance or result in a hollow looking appearance.
• Deformity: A deformity may be present if you have a fracture or a dislocation. Certain ligament tears can cause an abnormal positioning of the bony structures.

Self-Care at Home

Minor injuries that have only slight pain can be treated at home. If you do not know what is causing the pain, or if symptoms suggest you might have a more serious condition, you should contact your doctor while starting basic first aid.

• Use the injured area as little as possible for the first two to three days and then slowly begin to exercise the injured area. Exercise will speed recovery along with increase blood flow and nutrients to supporting structures of your joints, and decrease the stiffness you feel.
• Apply cold therapy such as Arctic Ease Cryotherapy Wraps or Pads® for the first 24 – 72 hours of an injury to reduce pain and inflammation. Arctic Ease Cryotherapy Wraps® are a two in one solution giving you both cold therapy and compression without limiting your mobility.
• Do not apply heat in the first week after an injury because it can increase the swelling in the injured area and make your pain worse.
• For pain control: Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) may be used, however check with your medical provider before starting or adding any medications.

When to Seek Medical Care

• If you have severe or worsening pain, weakness, numbness, coolness, deformity, or color changes, you should go to a hospital emergency department immediately.
• If you develop a high fever (temperature >102.5 F), a severe headache, any chest pain, shortness of breath, become dizzy or nauseous, or if you develop a sudden onset of numbness or weakness, particularly on one side of the body this maybe the sign that you are having a stroke. Call 911 for emergency services without delay.
• If pain or other symptoms get worse, call your doctor or immediately go to an Emergency Room.