How to tell if Shoulder Pain is Really Neck Pain in Disguise

When Shoulder Pain is Really Neck Pain in Disguise

Are you suffering from shoulder pain? Have you tried “shoulder exercises” from YouTube, TicTock, or Chat and the shoulder seems to be no better? Have you had shots to your shoulder with no effect? Are you worried that you are headed for surgery. Well, a recent study discovered that upwards of 80% of Shoulder pain is Neck Pain in Disguise. 

So, you may be treating the wrong joint. This is not to say that “nothing is going on in the shoulder”. You may very well have imaging showing a partial tear to the rotator cuff, arthritis, or labrum(shoulder capsule) issues. This is not to discount that. But rather, the neck may be making the shoulder more sensitive than it would ordinarily be which is why only targeting the shoulder might only be putting out a fire only for the neck to relight it. 

In this article, I’ll share a couple of tests that can help you figure out where your pain is coming from and more importantly what to do about it. 

How to tell if your shoulder pain is coming from your spine. 

First we have to understand just how the neck or upper back can cause shoulder pain. The simple of it is that all the alarm system wiring that reports on what is happening in the shoulders has to go through the upper back and neck, through the spinal cord, and to the brain in order for you to get the alert that something is wrong. 

Problems anywhere along that pathway can make the muscles and joints below it tight, tender, and painful. This is true even if you aren’t currently having neck pain. So, how to tell if your shoulder pain might have a neck contribution. 

1. Does your pain come and go? Does it change especially if you’ve been sitting for a long time? Is it worse when you’re sitting at your desk? 

2. If you do have neck issues, do you sometimes notice the pain in your shoulder, sometimes notice it between your shoulder blades, then sometimes the shoulder is OK but the neck is worse(pain kind of yo-yo’s between the neck and shoulder). Then your neck is likely a big contributor to your shoulder pain. 

3. Do you ever wonder or know that your posture is to blame for your shoulder pain? This is a sure sign that your spine is likely causing the shoulder issues. In fact, if you look at the picture below-if I can’t get my mid-back and neck into a good position, it is impossible to reach fully overhead. If my spine is rounded, then I automatically create impingement in the shoulder when I try to reach overhead. 

4. Do you have knots between your shoulder blades(these are often called trigger points) or knots between your neck and shoulder? This is usually another sign that the neck is involved in your shoulder pain. 

5. If you tilt your head towards the side of the shoulder pain then tilt it away from the side of the shoulder pain, do you have more movement on one side versus the other? The neck is often a cause(at our clinic in Midtown Tallahassee, we often find that if we clear up this 1 thing, we get most if not all shoulder pain to go away). 

What to do if you suspect your neck is the cause?

First, don’t panic. I’m not diagnosing a bulging disc, pinched nerve, or arthritis. Merely pointing out that some level of irritation around where the nerves come off the spine might be making the whole system more sensitive. Second, it is important to not fight pain with pain. This isn’t a “no pain-no gain” type of situation. Third, let’s do a posture reset. First, test how far you can move your shoulder in the painful direction.

Don’t push into pain, just check to see where the alarm starts going off. Then, start in the position of the picture on the left then gently arch your back while tilting your head back. 

Repeat back and forth about 15 times, again, not pushing into pain. 

Repeat several times then retest your shoulder. Does it move better, easier, or further before having pain? Then your spine is a likely contributor. 

You may be able to use this reset throughout your day to help your shoulder out. 

Next, if everything is too sore and tender to do the above then try laying on your back on your bed without a pillow. If your shoulder pain is on your left side, gently pull your left ear towards your left shoulder. Only go to stiffness then return to the starting position. Repeat about 15 times over a couple of sets. Recheck your shoulder mobility. If better, again, your neck might be part of the problem. 

So what happens if neither of these significantly relieve or improve your shoulder, does this mean that your neck isn’t involved. The short answer is no, it just means that a bit more TLC is needed along with more specific testing to find out the cause. 

Confused about where to start? Book a call from the comfort of your home or office and  on your schedule with one of our Chronic Pain Specialists. You can schedule your call here.  Need help now? Come by and talk with one of our Doctors of Physical Therapy at no charge. We offer FREE consultations, which give you the opportunity to come in and meet us and see for yourself how we can help you.

Here are just a few of the things you will learn in one of our free consultation:

• What is the underlying cause of your pain? (hopefully nothing too serious!)

• Roughly, how long will it take to fix the problem?

• What to do to help – which doesn’t include painkillers, resting or surgery etc.

• What other, natural, drug free methods are there to speed up recovery alongside treatment?

Our consultations are great for anyone that may be “unsure” if physio is right for them, and they give you the opportunity to ask questions and see for yourself if we can help you.

If you’d like one of our limited free consultation sessions, please click here to schedule your free consultation or CALL us on 850-765-2779 to make a no-obligation enquiry.

About the Author

Dr. Brandon is the owner and a Physio at Body Mechanix Physiotherapy and Fitness. Four of his favorite people call him daddy while he's been married to his other favorite person for 23 years. He enjoys teaching martial arts and is a Mestrando in Capoeira while in the mornings, he can be found working out with the guys in F3 around town.  He's the author of 4 pain relief guides for sciatica, low back, shoulder, and knees and the lead contributor to the Active Tallahassee Blog.