May 20, 2024

Zenith Tranquil

Information treatments and health conditions

Neck and Shoulder Pain: Causes and Treatment

7 min read

The neck and shoulders are complex and interconnected areas, and medical problems that affect one often affect the other, as well. Pain and dysfunction from injuries or conditions that impact the joints, muscles, and other structures can easily spread from the neck to the shoulder(s) and from the shoulder(s) to the neck.

These body parts share bones, muscles, connective tissues, and nerves, making it easy for pain to radiate throughout the area.

This article will describe the causes of neck and shoulder pain and what you can do to relieve symptoms.

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Neck and Shoulder Pain Causes

With a neck and shoulder pain combination, the underlying causes can be a wide variety of things, including some that originate in the neck and others that originate in the shoulders. Some of the more common ones include:

  • Cervical radiculopathy
  • Broken collarbone
  • Shoulder bursitis
  • Shoulder blade injury
  • Rotator cuff injury
  • Shoulder impingement syndrome
  • Soft tissue damage (sprain or strain)
  • Poor posture
  • Pleurisy 
  • Pericarditis 

Cervical Radiculopathy

One of the most common types of neck and shoulder pain is cervical radiculopathy, in which pain comes from compression or irritation of spinal nerve roots (the part where the nerve splits off from the spinal cord). These nerves travel between the neck vertebrae, through the shoulder, and down the arm. Cervical radiculopathy symptoms include:

  • Sharp or tingling pain in the neck, shoulder, arm, and hand
  • Sharp or aching pain in your neck when you look up
  • Headaches in the back of your head
  • Numbness
  • Weakness
  • Impaired reflexes

What Is the Cervical Spine?

The cervical spine is the neck region of your spinal column. It’s made up of seven small, highly mobile bones, and their associated ligaments, muscles, and shock-absorbing discs.

Anything that aggravates or comes into contact with your spinal nerve roots can lead to radiculopathy, and that includes several common conditions in which growths or abnormalities cause something to invade the space of the nerve root.

  • Herniated disc: The shock-absorbing discs between vertebrae can become damaged and may develop a bulge and/or leak fluid.
  • Synovial cyst: These lumps are caused by a buildup of joint fluid that forms a sac.
  • Bone spur: An extra bit of bone forms in response to damage or chronic inflammation.
  • Cervical spondylosis (neck arthritis): This condition involves the formation of bone spurs in the neck.
  • Spinal stenosis: An advanced stage of spinal arthritis, stenosis occurs when the spaces in the spine become narrowed, usually due to excess bone growth.
  • Degenerative disc disease (DDD): Discs between vertebrae erode and fray over time, which may cause a herniated disc. In cases of severe degeneration, bone-on-bone contact can cause bone spurs in the joint.

Broken Collarbone

Also called a clavicle fracture, this is a break of the bone that extends from the top of the sternum to the outer tip of the shoulder blade. Most broken collarbones are the result of falling on the shoulder itself or landing on an outstretched arm.

In addition to considerable pain and loss of function in the arm and shoulder, a broken collarbone can cause pain in the soft tissues that extend from the shoulder up into the neck.

Shoulder Bursitis

A bursa is a small sac of fluid in your joints that acts as a cushion and prevents excessive friction between bone and soft tissues. Bursitis is inflammation of the bursa, which can happen due to injury, infection, or disease.

Shoulder bursitis can cause swelling, stiffness, and pain in the shoulder joint that can radiate into the neck because of all the common structures and connections.

Rotator Cuff Injury

The rotator cuff is made up of the muscles and connective tissues surrounding your shoulder. Together, they keep your arm in the shoulder socket.

When these muscles and/or tendons are torn, it results in a rotator cuff injury. This may be caused by a sports injury or over time by repetitive wear and tear. You’ll most likely feel pain in your shoulder and possibly your neck, as well, when you try to move.

Shoulder Impingement Syndrome

Related to rotator cuff injuries, shoulder impingement syndrome refers to the compression of the tendons of the shoulder against the acromion, a bony prominence in the shoulder. The muscles and tendons of the rotator cuff are located in this “sub-acromial” area as well.

The compression occurs with repeated overhead movements such as those used in throwing a ball or swimming. Shoulder impingement may also occur as a result of an injury or fall, weakness in the shoulder muscles, or other things.

When the rotator cuff swells, it reduces the amount of space between the soft tissues and the acromion bone, which causes further friction. This creates a vicious cycle that’s hard to break.

Soft Tissue Damage

Soft tissue includes muscles, ligaments, tendons, and fascia (a thin covering around muscles, organs, and many other structures). These naturally pliable structures can be involved in pain relating to bones and joints, or they can be the entire cause of pain.

When you have neck pain, you may find that the muscles of your shoulders lose their strength. This, in turn, can lead to painful shoulder impingement and/or problems in your shoulder blade (the scapula).

Conversely, if you have pain in the acromioclavicular joint of your shoulder, which is located just above the topmost part of your arm, you may experience radiating pain in your neck.

Along with other types of trauma or injury to the neck, whiplash may lead to a ligament sprain or muscle strain. It’s likely to give you pain and restriction in both your neck and shoulder.

Poor Posture

Failing to sit up straight, especially if you’re at a desk all day, can take a toll on your neck and shoulder health. People who sit at desks all day may be prone to a rounding of the back (called kyphosis) and shoulders that slump forward.

This, in turn, can lead to a condition known as forward head posture. In this way, your shoulder and your neck may collude to create muscle tension and weakness, poor posture, and pain.


This condition involves swelling in the lining around the lungs and chest cavity. It can cause shoulder and neck pain when you take a deep breath.

Symptoms include sudden chest pain that may be felt only while coughing or breathing deeply, fever, cough, and shortness of breath.


Pericarditis is inflammation of the pericardium, which is the sac that surrounds the heart. One of the symptoms includes pain in the neck, shoulders, or chest when you take a breath. It gets worse if you lie down or breathe deeply.

Other signs of pericarditis are fever, weakness, and trouble breathing.

Take Pain Seriously

Issues involving your heart, lungs, abdominal organs, and spinal cord can all cause shoulder pain and sometimes neck pain. Take your symptoms seriously and see your healthcare provider as soon as you can after neck or shoulder pain starts.

How Is Neck and Shoulder Pain Diagnosed?

When you go to the healthcare provider complaining of neck and shoulder pain, expect a physical exam involving movement of the neck and shoulder so your healthcare provider can see what’s causing your pain and gauge your range of motion.

A physical therapist can perform a similar evaluation that includes range of motion and strength testing, as well as other special tests.

Depending on the results of your physical exam, you may be sent for imaging studies, which can include:

How to Relieve Shoulder and Neck Pain

You can take steps at home to try to relieve shoulder and neck pain when you feel it coming on. Some simple strategies include:

  • Applying an ice pack: Apply an ice pack or cold compress to the painful area for 20 minutes a few times a day to reduce inflammation.
  • Resting: Take a break from activities that could further strain your neck and shoulders.
  • Applying heat: Use a heating pad or take a warm bath to loosen tight muscles.
  • Taking over-the-counter pain relievers: Medication such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil or Motrin are designed to reduce pain.
  • Stretching: Doing sudden, jerky movements can make pain feel worse, but certain simple stretches, such as rolling your shoulders forward and backward or slowly moving your head from side to side, may help reduce pain.

What Is the Best Treatment for Shoulder and Neck Pain?

Most neck and shoulder injuries are treated conservatively, at least at first. Common treatments include:

If these approaches don’t work, some conditions may require surgery. Surgery is more likely if you have:

  • Persistent pain that leads to a decrease in function
  • Neurological symptoms in the arms and legs that are worsening
  • Problems with walking or balance

Some injuries, including rotator cuff tears, generally don’t benefit as much from conservative treatment, so surgery may be an early recommendation.

When to See a Healthcare Provider

The neck and shoulder are so connected and integrated with each other that just about any cause of pain in one area can cause pain in the other. If your neck/shoulder pain comes with troubling symptoms such as chest pain, trouble breathing, or weakness in the limbs, get immediate medical attention.

If your pain is persistent, getting worse, or interferes with sleep or daily activities, see a doctor of physical therapy. Physical therapists are movement experts trained on biomechanics of the body, including the neck and shoulder. They can help you identify the cause of your pain and find the right treatments for it so you can preserve or improve your function and quality of life.


Shoulder and neck pain often go together because the areas are so interconnected. Pain in these areas can be caused by many things, including a rotator cuff injury, shoulder bursitis, or poor posture. While icing, stretching, and resting the area may help, a healthcare provider can recommend formal treatment if pain persists. In more extreme cases, surgery may be recommended.


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