Shoulder and Neck Pain

An aching shoulder may not signal a shoulder problem. And a sore neck may not indicate a neck problem.
“People may come in with shoulder pain when they really have a neck problem,” says Eric Ricchetti, MD, a shoulder specialist in Cleveland Clinic’s Department of Orthopaedic Surgery. Conversely, neck pain can mask a shoulder problem.

 

“The way the body reports pain is somewhat unreliable,” explains E. Kano Mayer, MD, an interventional spine specialist in Cleveland Clinic’s Center for Spine Health. “Neck and shoulder pain so commonly overlap that some refer to it as ‘shneck’ pain.”
Why? Because the neck and shoulder are intimately connected by multiple nerve pathways. When injury occurs, the brain can’t always trace pain pathways back to their source, and what we feel may not be what is really going on. “This is known as ‘referred pain,’” says Dr. Mayer.

What Causes Shoulder and Neck Pain?

The most common cause of shoulder pain and neck pain is injury to the soft tissues, including the muscles, tendons, and ligaments within these structures. This can occur from whiplash or other injury to these areas.

  • Degenerative arthritis: of the spine in the neck (cervical spine) can pinch nerves that can cause both neck pain and shoulder pain. Degenerative disc disease in the neck (cervical spondylosis) can cause local neck pain or radiating pain from disc herniation, causing pinching of nerves (cervical radiculopathy). Abnormal conditions involving the spinal cord, heart, lungs, and some abdominal organs also can cause neck and shoulder pain.
  • Broken collarbone: Falling on your outstretched arm can cause your collarbone to break. This is particularly common when cyclers fall off of their bicycles.
  • Bursitis: A bursa is a sac over the joints to provide a cushion to the joints and muscles. These bursae can become swollen, stiff, and painful after injuries.
  • Heart attacks: Although the problem is the heart, heart attacks can cause shoulder or neck pain, known as “referred” pain.
  • Broken shoulder blade: An injury to the shoulder blade usually is associated with relatively forceful trauma.
  • Rotator cuff injuries: The rotator cuff is a group of tendons that support the shoulder. These tendons can be injured during lifting, when playing sports with a lot of throwing, or after repetitive use over a long time. This can lead to pain with motion of the shoulder due to shoulder impingement syndrome and eventually to a chronic loss of range of motion of the shoulder (frozen shoulder).
  • Shoulder or A-C separation: The collarbone (clavicle) and shoulder blade (scapula) are connected by ligaments. With trauma to the shoulder, these ligaments can be stretched or torn.
  • Whiplash injury: Injury to the ligamentous and muscular structures of the neck and shoulder can be caused by sudden acceleration or deceleration, as in a car accident. This can also cause muscle spasms in the neck and shoulder areas.
  • Tendonitis: The tendons connect the muscles to the bones. With strain, the tendons can become swollen and cause pain. This is also referred to as tendinitis.
  • Gallbladder disease: This can cause a pain referred to the right shoulder.


Dangers of Drugs for Shoulder and Neck Pain Treatment

Millions of Australians depend on anti-inflammatory drugs to relieve pain, but the drugs are among the most dangerous on the market. Aside from significantly increasing your heart risks (such as a two to fourfold increase in the risk of heart attacks, stroke or cardiovascular death), NSAIDs are linked to serious gastrointestinal risks like bleeding of the digestive tract, increased blood pressure and kidney problems. Remember, this applies not only to prescription medications like Celebrex but also to over-the-counter drugs like aspirin, Advil and Motrin.
It’s very difficult to find a drug-based method of pain relief that is not saddled with severe side effects. The FDA has even recently limited the amount of acetaminophen allowed in prescription products and added a boxed warning due to liver toxicity concerns. Acetaminophen is actually the leading cause of acute liver failure in the United States.

As for the opioid painkillers like OxyContin, they are among the most commonly abused prescription drugs and are a leading contributor to the rising rates of fatal prescription drug overdoses. Many become addicted after using them to treat conditions like back or neck pain.
But no matter what type of painkiller you choose, the bottom line to remember is that they do not come without risks! Unfortunately, if you visit your conventional doctor with severe neck pain, a long-term treatment plan will typically include a drug-combination approach, using anti-inflammatory drugs, anti-seizure medications, muscle relaxants and possibly other types of pain medication as well. In other words, the answer for pain relief is drugs, drugs and more drugs — each one raising your risk of suffering potentially lethal side effects.
Powerful drugs can numb your nervous system so the pain doesn’t register. While these approaches may be convenient, they can cause adverse effects and kidney or liver damage. Worse, they don’t correct the underlying cause of the headache.

How to Relieve Shoulder and Neck Pain Naturally

  • Resting from activities that aggravate pain
  • Physical therapy exercises
  • Icing the shoulder, especially at night
  • Anti-inflammatory medications
  • Cortisone injections to reduce inflammation in the shoulder
  • Physical therapy, including posture therapy
  • Anti-inflammatory medications and /or muscle relaxants
  • Ice, heat and massage therapy
  • Injection of cortisone to reduce inflammation or local anesthetics to relieve pain
  • Chiropractic Care:Chiropractic works by opening stuck joints, returning movement to the spine, and removing any nerve impingement that might be happening. If a disc herniation is involved, chiropractic is a natural way to provide a long-term solution. Chiropractic gets to the source of the problem, not just addressing the symptoms but finding the area of dysfunction and returning it normal physiology—in other words, making the area work the way it’s supposed to.
When function returns, pain goes away. But mind you, getting rid of pain is not the only name of the game as far as chiropractic is concerned; return to function is the real goal, because when function returns, pain goes away on its own. Pain is nothing more than a warning signal telling you when something is wrong. Shutting off the alarm instead of investigating what is causing the alarm to go off only sets you up for a recurring problem. Once found, the solution can then be applied.