Neck pain is experienced by many people in their day to day lives. Pain in Neck often results from poor posture, strained muscles, previous injuries or degenerative conditions. However, neck pain may not necessarily be limited to the neck region only. The area affected in neck problems can extend up to the shoulders, resulting in shoulder pain.

Neck and Shoulder Pain

Shoulder pain can be related to the shoulders and arms, but it can also be an outcome of neck problems. When a person presents with shoulder pain, it is important to assess the condition, clinically examine and perform appropriate tests and investigations to evaluate the origin of the problem.

Shoulder pain can arise out of shoulder problems or can be an extension of neck pain. Soreness of neck can present itself with a painful shoulder. Neck pain and shoulder pain are commonly present in association with each other. Such overlapping pain, also called as 'shneck' pain, may be difficult to evaluate, so understanding the difference is necessary.

Causes of Neck Pain

A sore neck may be presented in case of injuries to the neck, resulting from falls, accidents or blows. Neck pain can occur due to poor postural habits or strained muscles of the neck, which make them tensed, painful and stiff. People working in occupations with repeated neck movements, office work, long hours of writing or operating computer, lifting of heavy weights, excessive overhead activities can experience repeated stress on the neck muscles.

Other conditions like cervical spondylosis, herniated disc or cervical disc disease, etc. can cause neck pain and discomfort. Neck pain may also be seen in some infections like meningitis or due to the presence of tumors or disorders of the surrounding tissues.

Whatever, may be the cause of neck problem, it is generally presented with neck pain and discomfort. Often neck movements may be restricted and pain may worsen on moving the neck upwards or downwards and to the sides. Neck pain may also be felt on holding the neck for long, like long hours of reading, travelling, office work or after physical exertion and exercise. The neck muscles become sore and stiff, adding to the discomfort.

• Muscle Pain - The muscles of the neck extend to the shoulders. When these muscles get strained due to overwork, or remain stiff due to neck pain, the entire muscle becomes sore. Hence, neck pain can gradually extend to the shoulder pain. Pain may worsen on movement of shoulders like raising the arm, lifting weight or other hand movements. Pain can also extend to the back or front of shoulders and the shoulder blade.
• Nerve Pain - Another common reason of neck pain extending to the shoulders, is when the nerves in the cervical region get affected. In certain conditions, like disc prolapse, bone spurs or extreme muscle spasms of the neck, the nerve roots can get trapped. This leads to compression or pinching of nerves and causes pain in shoulders, arms and hands, which are the areas supplied by those nerves. Such pain is sharp, shooting and may be associated with numbness, tingling or burning sensation.

Shoulder pain arising due to neck pain often has characteristic features, which when present, involvement of the neck should be suspected.

• Pain in the neck region, radiating to the shoulders, arms and hands.
• Burning, tingling sensation or shooting pain in shoulders and arms.
• Shoulder and neck pain worsens on movement of neck.
• Shoulder pain is relieved when neck is supported, rested or when lying down.
• Using a neck brace, cold or warm compresses to the neck, provide relief to shoulder pain and reduce stiffness.

Some features that may be noted when shoulder pain is more local and may not be necessarily related to the neck include:

• Dull aching shoulder pain, may be around arms but not the hands.
• Shoulder pain worsens on movements of the shoulder and not of the neck.
• Pain in shoulder is experienced after a fall or blow to the shoulder.
• Shoulder pain is relieved after resting or supporting the arm.

The nature of shoulder pain can give a rough idea about the possible relation to the neck pain. However, a thorough clinical examination of the neck and shoulder region is essential. The muscles are often stiff, tensed and tender to touch. Appropriate investigations should be done, depending on the history and clinical picture.

Shoulder pain arising from neck pain can be relieved by applying ice packs, warm compresses or gently massaging the neck and shoulder area. Medicines like muscle relaxants and pain killers may be given. Physical therapy and strengthening exercises for the neck and shoulders, should be performed to improve strength and flexibility and range of motion.