So does neck pain give shoulder pain ? Or does shoulder pain give neck pain ?
Confused ? Let's see if we can dispel some of the confusion
The body is not always reliable when it comes to reporting pain. Confusing hip pain with back pain is common enough but in my experience it's even more common with the shoulder and neck. Now in some instances it is obvious where the pain is coming from - by that I mean things like broken bones, an obvious early ' freezing ' shoulder or a whiplash..... that's not really what this blog is addressing. I'm talking about that niggly neck pain that you woke up with last month and hasn't really cleared and now your shoulder blade hurts and you are struggling to get comfy in bed...... maybe we should call it shneck pain ?
So...are you calling us and telling us your neck hurts ? Or your shoulder ? Or both ?
And does it really matter ?!
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Neck and shoulder : what do they have in common
Both these areas have a BIG range of movement which is uber important. I remember our Anatomy lecturer Miss Price (rest her soul ) teaching us that the neck serves the eyes and the shoulder serves the hand. Basically, the huge ranges of movement allow the eyes and the hand to be placed in pretty much any direction, improving our hunting and functional abiities. Additionally they also both have to be stable enough to support our body weight and the weight of the head ( about 7lb according to Brad PItt in Se7en )...... It's a proper balancing act and a big ask for any joint so no wonder problems are common.
Generally speaking the more complex a machine is, a car for instance, the more potential there is for something to go wrong. The neck and in particular the shoulder, are probably the most dynamically complex parts of our bodies, both structurally and in how they function, sharing many muscles and nerves. Remember it's not just ' dem, dem bones' that are connected.... just look how the muscles intertwine and overlap.
Symptoms of Neck Pain and Shoulder Pain:
Neck and shoulder ( or Shneck pain ) can range from a mild niggle in certain positions to excruciating pain disturbing sleep and seriously hampering function of the whole arm. It may make the head feel like a ten tonne bowling ball and fairly basic functions like dressing, driving, lifting and working can be affected. The whole neck and shoulder complex must be examined including the collarbone, shoulder blade and the shoulder joint proper. It is not common for primary shoulder problems to cause pins and needles or numbness BUT the plumbing and wiring of the whole upper quardant region is very complex so never say never !
Common Causes of Neck Pain:
Muscle Strain:Â Overexertion, whether acute or a chronic overload, can strain the muscles and ligaments in your neck, leading to pain.
Herniated Disc:Â The discs between your vertebrae can bulge or rupture, pressing on nerves and causing referred pain down the arms and shoulder blade region.
Spinal Stenosis:Â This condition involves the physical narrowing of the spinal canal, which can compress nerves and lead to discomfort.
Osteoarthritis:Â The wear and tear of aging can cause the cartilage in your spine to deteriorate, leading to pain and stiffness.
" Â Remember it's not just 'dem, dem bones' that are connected
Common Causes of Shoulder Pain:
Rotator Cuff Degeneration:Â The rotator cuff muscles in the shoulder act as stabilisers and can exhibit wear and tear as we age ( rather like grey hair and wrinkles ).
Bursitis:Â Inflammation of the bursae, the small fluid-filled sacs that cushion the shoulder and shoulder girdle joints, can cause sharp pain, especially when moving.
Joint Arthritis:Â Any of the trio of joint that make up the shoulder complex can develop arthritis causing swelling and stiffness in the joints. This can alter movement patterns
Tendinitis:Â Overuse and poor movement patterns can lead to inflammation of the tendons around the shoulder complex
Differentiating Between Neck and Shoulder Pain
This is the controversial paragraph ...... I'm not sure an exact diagnosis always matters.
I would wager that in clinic around 85% of the more overuse, chronic type 'shneck' type pains that we see it's a combination of BOTH joints causing the problem. Sure it may have started as a muscle strain within the neck or rotator cuff but over time the pain causes faulty movement patterns and adaptations to our posture and function meaning that the other joint joins in the pain party too.......a bit like the old chicken and egg conundrum. Whether it started in the neck or the shoulder is immaterial as we are probably going to treat BOTH. It is however important to EXCLUDE certain diagnoses :
To EXCLUDE:
Radicular Neck Pain:Â Nerve pain originating in the neck - usually involving the cervical discs causing pressure or irritation on the nerves as they exit the bony neck column
Cuff tendon tears :Â Large cuff tears can be very disabling and in some cases are treated by surgical or injection intervention.
Instabilities ( shoulder ) :Â Pain associated with the joints not being held in the correct position. This can happen to any of the trio of joints of the shoulder complex.
The above named all have specific structural changes in the tissues and as such need a slightly different approach.
Conclusion?
Look, I'm not suggesting there should be a ' one top shop ' for ALL pains in the neck and shoulder complex, rather that I think trying to pinpoint exactly whether the shneck pain started in the neck or shoulder is probably not necessary as it becomes a chicken and egg scenario. Thisis one instance when it doesn't really matter which started first. An experienced therapist can examine and determine the best approach to getting you better. I won't lie, the shoulder probably more than any other joint takes persistence and exercise so yu want to make sure you are doing appropriate ones for YOUR condition otherwise you could be barking up the wrong tree. Remember, you don’t have to live with pain—help is available, and with the right approach, you can get back to doing the things you love.
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