What Causes Neck and Shoulder Pain

This condition occurs when nerves and/or blood vessels become compressed within the thoracic outlet (the small area between the top rib and collarbone). Thoracic outlet syndrome most commonly causes pain, tingling, numbness, or weakness in the shoulder and/or arm. It may also be accompanied by neck pain. When thoracic outlet syndrome is caused by compressed blood vessels, the neck pain may feel hot or cold due to poor circulation. When nerves are compressed, the tingling or numbness may be felt in the neck.

What Causes Concurrent Neck and Shoulder Pain, and How Do I Treat It?

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Simultaneous pain in the neck and shoulder is common, and is usually the result of a strain or sprain.

Pain can range from mild to very severe and can include:

tingling
shooting pain
stiffness
numbness
spasms
soreness

In some cases, neck and shoulder pain can be a sign of a heart attack or a stroke. These are serious medical emergencies that require immediate help.

Rarely, it can be caused by gallstones and certain cancers.

Most neck and shoulder pain is due to sprains and strains from sports, overexertion, or incorrect posture.

Soft tissue injuries

Neck and shoulder pain is often due to an injury of the soft tissue. Soft tissue includes your muscles, tendons, and ligaments. The term is used to distinguish it from the hard tissue of bones and cartilage.

Soft tissue injuries can cause many kinds of pain, including:

Rotator cuff tear

The rotator cuff is a group of four tendons that hold your upper arm (humerus) into your shoulder blade.

A rotator cuff tear can be caused by a singular injury (such as a fall) or by repeated stress over time, which can be common in sports that require a lot of arm and shoulder use.

Aging can also contribute to rotator cuff tears. Reduced blood supply can slow down the body’s natural ability to repair damage. And bone spurs can form at the joint, damaging the rotator cuff tendons.

A sudden tear will usually cause intense pain in your shoulder and immediate weakness in your upper arm.

Tears due to repetitive use may cause shoulder pain and arm weakness over time. Activities that require reaching up or behind, such as combing your hair, may become painful.

Whiplash

Whiplash is the tearing of muscles, tendons, and ligaments in your neck from a sudden movement of your neck. It typically occurs in an auto collision.

Other common causes include:

contact sports
being shaken
falls
a blow to the head

Symptoms can take 24 hours or longer to appear and include:

neck pain and stiffness
headaches
dizziness
blurred vision
constant tiredness

Most people recover fully within three months but some can have chronic pain and headaches for years afterward.

Cervical spondylosis (cervical osteoarthritis)

Cervical spondylosis is the name given to age-related wear of the spinal discs of your neck. It’s a very common condition, affecting more than 85 percent of people over age 60.

Your spine is made up of bony segments known as vertebrae. In between each vertebra is soft material known as discs.

As you age, your discs lose water content and become stiffer. Your vertebrae move closer together. This can irritate the lining of the joints in a condition known as cervical osteoarthritis.

As part of the arthritis, you can also develop bone spurs.

Symptoms of cervical osteoarthritis typically include neck pain and stiffness. In more severe cases it can lead to a pinched nerve.

Pinched nerve (cervical radiculopathy)

A pinched nerve in your neck can cause pain that radiates toward your shoulder. This is also known as cervical radiculopathy.

Cervical radiculopathy most often comes from changes in your spine due to aging or injury.

Bone spurs can cause a pinching of the nerves that run through the hollow space in the vertebrae. If this happens in your neck, it can cause a pinched nerve.

tingling or numbness in your fingers or hand
weakness in the muscles of your arm, shoulder, or hand

Herniated disc

When cervical discs shrink, vertebrae come closer together and can sometimes lead to one or more of the discs getting damaged.

If the soft inner portion of a disc protrudes through its harder exterior, it’s called a slipped, herniated, or prolapsed disc.

Symptoms of a slipped or herniated disc include:

pain
numbness
tingling
aching
a burning sensation in your neck

Posture and sleeping position

Holding your neck in an awkward position for a prolonged time can lead to strains in the muscles and tendons of your neck and shoulders.

Heart attack

While sudden pain in the chest or arms may be a sign of a heart attack, pain and numbness in the neck, back, or jaw are also symptoms.

Medical emergency

Call 911 or go to the nearest emergency room if you feel sudden pain in the neck, back, or jaw that comes on without trauma.

Stable angina

Pain in the shoulders, neck, back, or jaw can also be a symptom of stable angina. It occurs when the heart isn’t getting enough oxygen due to a narrowing of the coronary arteries.

There’s usually pain in the center of the chest, which can spread to the left arm, shoulders, neck, back, and jaw.

It should be diagnosed and treated promptly.

Stroke or cervical artery dissection

Neck pain can be a symptom of a serious type of stroke called cervical artery dissection. This condition is rare but it’s one of the most common causes of stroke in people under 50.

Symptoms of a stroke include:

drooping of the face
arm numbness of weakness
difficulty speaking or slurred speech
vision trouble
difficulty walking

Medical emergency

If you believe you or someone else may be having a stroke, call 911 or go to the nearest emergency room.

Broken collarbone (clavicle)

The collarbone (clavicle) is the slightly curved bone at the top of your chest that runs from your shoulder blades to your rib cage.

Clavicle fractures often happen when you fall on your outstretched arm.

Signs of a broken clavicle include:

intense pain
an inability to lift your arm
a sagging shoulder
bruising, swelling, and tenderness

Broken shoulder blade (scapula)

The shoulder blade (scapula) is the large, triangular bone that connects your upper arm to the collarbone.

Scapula fractures can happen in high-impact injuries such as motorcycle or motor vehicle collisions.

Symptoms include intense pain when you move your arm and swelling at the back of your shoulder.

Frozen shoulder (adhesive capsulitis)

Frozen shoulder is a condition where it becomes increasingly difficult and painful to move your shoulder. People between 40 and 60 years old and people with diabetes are at greatest risk.

The cause is not known.

The main symptom of frozen shoulder is a dull or aching pain usually located over the outer shoulder and sometimes the upper arm.

Shoulder tendinitis or bursitis

Tendons are strong fibers that attach muscles to your bone. Bursa are fluid-filled sacs that prevent friction at joints.

Inflammation of the tendons (tendinitis) and the bursa (bursitis) are common causes of shoulder pain, but pain can occur anywhere that inflammation occurs.

The tendons and bursa around your rotator cuff are especially prone to inflammation that causes pain and stiffness around your shoulder.

Shoulder separation

Shoulder separation is an injury to the joint where the collarbone meets the highest point (acromion) of your shoulder blade. The joint is called the acromioclavicular (AC) joint.

Injury to the AC joint commonly happens when you fall directly on your shoulder. Severity can range from a minor sprain to a complete separation that shows a large bump or bulge above the shoulder.

Pain can occur in the surrounding areas.

Shoulder and neck referred pain

Because of the close connection of the nerves serving them, shoulder and neck pain are often mistaken for one another.

You may feel a pain in the shoulder that’s actually coming from your neck, and vice versa. This is called referred pain.

Some of the symptoms of referred pain from your neck include:

stabbing, burning, or electric-like tingling pain
pain that radiates to your shoulder blade, elbow, and hand
pain that radiates down your arm when you twist your neck
pain that’s relieved when you support your neck

Gallstones or enlarged gallbladder

Pain in your right shoulder can be a sign of a gallstone blocking a duct in your gallbladder. You may also feel pain in your back between your shoulder blades. The pain may be sudden and sharp.

You may or may not feel the more common symptoms of gallstones or gallbladder inflammation. These are:

sudden pain in your upper right abdomen
pain in the center of your abdomen, below your breast bone
nausea or vomiting

Cancer

In some cases persistent neck pain can be a symptom of head or neck cancer.

The most common causes of head and neck cancer are excessive use of alcohol and tobacco. These account for around 75 percent of cases .

Referred pain in the shoulder can also be a symptom of lung cancer.

What Causes Neck and Shoulder Pain?

When neck pain and shoulder pain occur together, some people may find the neck pain more concerning. For others, the shoulder pain may be more painful or limit more activities. Depending on the cause of the pain, it is also possible for the neck and shoulder pain to alternate in intensity during different activities.

Learn about issues and conditions that can cause neck pain. Watch: Neck Pain Causes Video

Below are some of the potential causes of neck and shoulder pain to appear at the same time.

Common Causes of Neck and Shoulder Pain

Some of the more common causes of neck and shoulder pain include:

Cervical herniated disc

When a cervical disc’s tough outer layer (annulus fibrosus) tears or partially tears and the soft inner layer (nucleus pulposus) starts to leak outward, the nearby nerve root can become inflamed and painful. If a disc in the lower cervical spine herniates, radicular pain in the shoulder blade region may accompany the neck pain.

Cervical spondylosis

Degeneration in the cervical spine, also called cervical spondylosis, can involve cervical osteoarthritis, cervical degenerative disc disease, and other wear-and-tear conditions of the spine. As the spine eventually starts to degenerate with age, one or more intervertebral foramen (bony openings where the spinal nerves exit the spinal canal) may become smaller, called foraminal stenosis. With less room, a spinal nerve may become compressed or inflamed, causing pain to radiate from the neck down into the shoulder.

Muscle strain

Several muscles are connected to both the neck and shoulder, such as the levator scapulae and trapezius. When one of these muscles becomes strained, pain and stiffness may be felt in both the neck and shoulder. Even in cases where a muscle strain develops in only the neck or shoulder, the pain may be referred to a nearby body region.

Stinger injury

When a collision causes the neck to bend sideways, it may overstretch the nerves between the neck and shoulder, causing a stinger injury. A stinger injury, also called a burner, typically results in a shock-like pain that shoots down the arm and may also include some tingling, weakness, or numbness. Stingers usually go away quickly, but they may last longer. A sports collision, such as during football or hockey, is a common cause of stinger injury.

Read more about Stinger Injuries on Sports-health.com

Sometimes neck and shoulder pain may have more than one cause. For example, a traumatic injury, such as a car collision or falling from a ladder, may cause a herniated disc, fracture, and muscle strain that all contribute to the neck and shoulder pain.

Other Causes of Neck and Shoulder Pain

Some less common causes of neck and shoulder pain may include:

Thoracic outlet syndrome

This condition occurs when nerves and/or blood vessels become compressed within the thoracic outlet (the small area between the top rib and collarbone). Thoracic outlet syndrome most commonly causes pain, tingling, numbness, or weakness in the shoulder and/or arm. It may also be accompanied by neck pain. When thoracic outlet syndrome is caused by compressed blood vessels, the neck pain may feel hot or cold due to poor circulation. When nerves are compressed, the tingling or numbness may be felt in the neck.

Brachial neuritis

When inflammation or damage occurs in the brachial plexus—a group of nerves that travel through the shoulder from the lower neck and upper back—it is called brachial neuritis. This condition typically starts suddenly, such as with sharp or electric shock-like pain. While brachial neuritis pain is usually felt on one side of the body in the shoulder or arm, it may also be felt in the neck. Tingling, numbness, and/or weakness may also go into the shoulder, arm, or hand.

Cervical myofascial pain syndrome

This condition of unknown cause includes painful trigger points in the neck’s muscles and fascia (connective tissues). When a trigger point in the neck is pressed, it may refer pain down into the shoulder or other nearby areas.

Shoulder osteoarthritis

The breakdown of protective cartilage within the shoulder joint can lead to pain and inflammation. Degenerative changes within the shoulder joint may also cause nerve compression that radiates pain up to the neck. 1 Arthritis of the Shoulder. American Academy of Orthopaedic Surgeons website. http://orthoinfo.aaos.org/topic.cfm?topic=a00222. Last reviewed: January 2013. Accessed August 8, 2019.

Read more about Shoulder Osteoarthritis on Arthritis-health.com

Fibromyalgia

This syndrome typically involves widespread pain, fatigue, tender points, and commonly coexists with mental health issues such as depression or anxiety. The myofascial pain is often associated with trigger points that may be present in various parts of the body, especially in the neck and shoulders. Trigger points may feel tender or tight, and they can refer pain to nearby areas when pressed.

Many other causes of neck and shoulder pain exist. Visit a doctor for any neck or shoulder pain that persists for more than a week or two. If pain is accompanied by any troublesome signs or symptoms, such as weakness, numbness, dizziness, nausea, or problems with coordination, seek immediate medical attention.

Neck And Shoulder Pain

What Causes Neck and Shoulder Pain

What Causes Concurrent Neck and Shoulder Pain, and How Do I Treat It?