Shoulder and Neck Pain: Causes and Treatment

A Brief Overview of Shoulder & Neck Pain

Shoulder and neck pain can make life miserable. Pain in the neck, shoulder, and back is caused by problems with the soft tissues (muscles, ligaments and tendons) and bones. Neck pain causes include whiplash, muscle strain or tension, or injury to the vertebrae. Shoulder pain can have diverse causes such as tendonitis, dislocation, bursitis, rotator cuff injury, or joint injury. A broken collarbone or other broken bones can also cause significant discomfort and pain in the shoulders and neck.

  • The shoulder joint is a very mobile joint which makes it very susceptible to injury. Most shoulder pain problems fall into one of these three categories: tendonitis/bursitis, injury or instability of the joint, or arthritic disease. 
  • Rotator cuff syndrome is a strain or sprain or tear of the tendons that make up the rotator cuff. 
  • Rarely, tumors, infections and nerve damage cause shoulder pain.
  • Much neck pain is caused by soft tissue damage due to injuries such as whiplash or wear and tear due to overuse. 
  • Damage to spine joints and bones, such as cervical disk degeneration, arthritis, or traumatic injury can cause severe pain and disability. 
  • Fibromyalgia (whole body pain syndrome) can contribute to neck and upper back pain. Poor posture while performing every day activities can also cause significant neck pain. Rarely, infections or tumors will cause neck pain.

Neck and shoulder pain should be evaluated by a doctor if the pain is severe, persistent or if you have had an accident or injury to these areas. X-rays, MRI (magnetic resonance imaging) scans, and CT (computerized tomography) scans are typically used in conjunction with physical exam to determine the cause of pain. If your doctor suspects your neck pain is caused by meningitis, a spinal tap and further medical testing will be done to rule out this serious disease.

Depending on the cause, your doctor may suggest non-surgical treatment for your neck and shoulder pain. This include use of anti-inflammatory medication or acetaminophen, use of heat or ice on the painful area, gentle range of motion exercises, and/or massage. You may have a local corticosteroid injection into painful joints. If a muscle spasm is causing your pain, you may be prescribed a muscle relaxant. Neck pain may also be treated with a neck collar and you may need to change your sleeping pattern.

Some cases of neck and shoulder pain will need to be treated surgically. Rotator cuff tears may be treated with surgery to repair the tear or to clean up the injured tissues. Surgery, either arthroscopic (use of small incisions and small instruments) or open (larger incisions), can repair other damaged tissues or joints. Other cases will need to be evaluated on a case-by-case basis to determine the best course of action to take in order to manage your pain.