Neck and shoulder pain can happen in different ways. Some people feel pain only in their neck or only in their shoulder, while others feel pain in both areas.
If you have pain in your neck and shoulder at the same time, it’s usually because of an injury, but it can also be related to health conditions, like a heart attack. The treatment you need depends on what’s causing the pain.
It’s common to have both neck and shoulder pain together, often from a strain or sprain. The pain can vary from mild to very severe, and you might feel things like tingling, shooting pain, stiffness, numbness, spasms, or soreness.
In some cases, neck and shoulder pain could be a sign of a serious health emergency, like a heart attack or stroke. If you suspect this, it’s crucial to get immediate help.
Although rare, gallstones and certain cancers can also cause neck and shoulder pain.
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Causes of Neck and Shoulder Pain
Neck and shoulder pain can arise from a variety of causes, often involving the muscles, nerves, bones, joints, or connective tissues. Here are some of the most common causes:
- Overuse or improper use of muscles.
- The herniation of a disc in the neck.
- Age-related wear and tear.
- Inflammation of the rotator cuff.
- Injuries to the bones in the neck or shoulder.
- Long periods of sitting or standing with poor posture.
Some medical conditions might also be the primary causes:
- Cervical Radiculopathy: Often caused by a pinched nerve in the neck, this condition can lead to pain and neurological symptoms that radiate from the neck to the shoulder and down the arm.
- Fibromyalgia: A condition characterized by widespread musculoskeletal pain, which often includes the neck and shoulder areas.
- Rheumatoid Arthritis: An autoimmune disease that can cause pain and swollen joints, including those in the neck and shoulders.
- Osteoarthritis: Degeneration of the cartilage in the joint can cause neck and shoulder pain.
Sometimes, pain in the shoulder or neck can be a sign of a heart attack, especially if it occurs with other symptoms like chest pain or shortness of breath.
Diagnosing Neck and Shoulder Pain
Doctors will physically examine you and take a medical history to determine the causes of your neck and shoulder pain. The following are some common tests:
X-rays: These show if there’s a space narrowing between spinal bones, any arthritis-like issues, tumors, slipped discs, spinal canal narrowing, fractures, or instability in the spinal column.
MRI (Magnetic Resonance Imaging): This helps see detailed nerve-related problems, along with issues in tendons and ligaments. It’s a painless test.
Myelography/CT Scanning: Sometimes used instead of an MRI.
Electrodiagnostic Studies: Tests like EMG and NCV help find reasons for neck and shoulder pain, arm pain, numbness, and tingling.
How to Treat Neck and Shoulder Pain
When you have neck and shoulder pain, the treatment depends on what’s causing it.
If it’s something serious like a heart attack or stroke, you need emergency help. But for most other cases, you can try things at home to feel better. Home remedies, physical therapy, and massage can help improve the pain.
Here are some remedies you can try:
Rest: Taking a break from activities that worsen the pain or strain the affected area, particularly sports or physically demanding tasks, can provide much-needed relief.
Ice and heat therapy: Applying an ice pack wrapped in a towel to the affected area for the first three days after pain onset helps reduce swelling. Afterward, using a heating pad or warm compress to promote blood flow and relaxes the muscles.
Over-the-counter pain relievers: Non-prescription pain medications like ibuprofen or acetaminophen can help reduce pain and inflammation. You should follow the recommended dosage and consult a healthcare professional if needed.
Pain-relieving shoulder wraps: Specialized wraps or braces designed to reduce swelling and provide support to the affected area can be beneficial in managing pain.
Gentle massage: Massaging the neck and shoulder area with gentle pressure can help relieve tension and promote relaxation.
Topical pain-relieving creams: Over-the-counter creams or gels containing ingredients like menthol or capsaicin can provide temporary relief when applied to the affected area.
Exercises for Neck and Shoulder Pain
Here are some simple exercises to help with neck and shoulder pain. These are easy stretches that can relieve stiffness.
If your pain gets worse while doing these exercises, or if it’s already severe, it’s important to stop and consult a doctor.
Sometimes, a doctor might recommend a physical therapist. They can focus on your muscles and soft tissues to ease the pain. The therapist may also suggest specific exercises for you to do at home. These exercises are designed to strengthen your neck and shoulders, reducing the risk of future injuries.
You can do the stretches as three or four cycles. If you experience any discomfort or increased pain, remember to stop and consult with a healthcare professional.
Neck Stretches
- Sit comfortably.
- Gently lower your chin to your chest, holding for 5 to 10 seconds.
- Slowly tilt your head back, looking at the ceiling, and hold for 5 to 10 seconds.
- Tilt your head to the right, aiming your ear toward your shoulder. Keep your shoulder relaxed and hold for 5 to 10 seconds.
- Repeat the tilt to the left side.
- Gently rotate your head to the right, as if looking over your shoulder. Hold for 5 to 10 seconds.
- Repeat the rotation to the left side.
Shoulder Stretch
- Stand in a doorway with your arms bent at a right angle, resting your hands on the door frame.
- Gently lean forward until you sense a mild stretch under your collarbone.
- Hold this position for 5 to 10 seconds.
Levator scapula stretch
- Stand next to a wall with your side facing it.
- Bend your arm at the elbow, creating a right angle.
- Turn your head to the opposite side, tilting it down until you sense a gentle stretch in your neck and back.
- Hold this position for 5 to 10 seconds.
- Repeat the stretch on the other side.
How to Prevent Neck and Shoulder Pain
You can avoid neck and shoulder pain by paying attention to how you sit and walk. Here are some simple tips:
Practice Good Posture
Stand against a wall and line up your shoulders, hips, and heels. Move your hands up and down the wall ten times. This helps you stand and sit straight.
Stretch and Exercise
Make a routine to stretch your neck, shoulders, and back. You can use the wall exercise mentioned earlier or ask your doctor for advice. Remember to do exercises properly to avoid hurting yourself.
Workplace Changes
If your work involves repeating the same movements, it can strain your neck and shoulders. Here are some changes you can make:
- If you talk on the phone a lot, use a headset. Don’t strain your neck and shoulders by holding the phone.
- Sit in a chair that supports your back properly.
- Take regular breaks to give your muscles a rest.
Move Around
If you sit a lot, stand up and walk around every 30 minutes. It’s a good way to break up long periods of sitting.
When to See a Doctor
While home remedies and exercises can provide relief for mild neck and shoulder pain, you might need to seek medical attention if:
- Your range of motion is significantly limited.
- The pain is severe and impacting your daily activities.
- You believe you’re experiencing a medical emergency, such as a heart attack or stroke.
Keep in mind that medical evaluation is necessary if the pain persists, worsens, or recurs after initial improvement.
Sophia Anderson, PT, DPT is a physical therapist who offers online pain management consultations. She helps people with various types of pain, especially neck, back, and knee pain.
She graduated from the University of St. Augustine with a Doctor of Physical Therapy (DPT) degree. She has experience in orthopedic physical therapy, sports medicine, neurological rehabilitation, advanced assessment and treatment of running injuries, and advanced treatment of the pelvic complex, spine, and extremities.
If you’re experiencing any pain, let Sophia Anderson, PT, DPT help you out.