Neck and shoulder pain can range from a minor annoyance to a disabling condition. The causes of pain in the neck and shoulder area are as complex as the options for treating your discomfort. Thanks to advances in our understanding of the muscles, joints, and bones that support the neck and shoulder region, pain treatments can be customized so you can find better and more effective pain relief. But with so many possible culprits for neck or shoulder pain, how do you know what treatments could help? These seven common causes for neck and shoulder pain and nine treatment methods will help you identify the source of your discomfort and prepare for your next visit with a physician or pain specialist.
What causes neck and shoulder pain?
Neck and shoulder pain originate from a myriad of causes. Some pain is due to wear-and-tear on the body over time while other discomfort stems from an acute injury.
Common causes of neck and shoulder pain include:
- Frozen shoulder syndrome
- Poor posture (and other wear-and-tear conditions)
- Spinal stenosis
- Pinched nerve (also called cervical radiculopathy)
If your neck or shoulder pain started immediately, you might already know the cause: an injury. Pain and discomfort in your neck or shoulders can happen to anyone when you’re at the gym, on the field, in the car, or on the job.
Even if your pain feels minor, seeking treatment as soon as you can could go a long way to preventing your condition from worsening. Following an injury, your body will adjust to lessen the pain, leading you to overcompensate in other muscles and joints in order to keep you going.
Without care, a minor injury can cause a ripple effect as other parts of your body sustain more stress and wear and tear. This could lead to a more chronic condition, such as arthritis and tissue damage.
There’s nothing tender about dull aching shoulder pain known as rotator cuff tendonitis, which gets its name from tendons, the cords that connect your muscles to bones.
This discomfort worsens when you move your muscle or joint, and you may see swelling. Tendonitis is most often caused by the repetitive stress we put on tendons in the course of our jobs, hobbies, and physical activities.
Athletes are especially at risk for experiencing tendonitis—hence the more informal terms “swimmer’s shoulder” and “pitcher’s shoulder”—as well as the elderly, since tendons lose flexibility with age.
Ever felt a sharp flash of pain in your neck after a rollercoaster ride? You might have been experiencing a minor case whiplash, and it doesn’t only happen at an amusement park.
This fairly common pain generally occurs from:
- Car accidents
- Contact sports
- Physical assault
- Any other sudden back-and-forth movement in your neck
Typically, pain begins within 24 hours of the injury, but it can start days or even weeks later. It manifests as tightness and stiffness in the neck with pain that worsens with movement. Whiplash is often accompanied by headaches, fatigue, and a numbness or tingling sensation in the arms.
If your shoulder feels like it just won’t move, frozen shoulder syndrome could be the culprit.
Frozen shoulder is a fairly common ailment that’s often caused by an injury or inflammation of the soft tissue around the shoulder’s glenohumeral joint. This condition occurs when the glenohumeral joint “freezes” because its surrounding protective capsule stiffens or contracts, limiting your mobility.
If your shoulder has been recently injured, keeping your shoulder in a sling can contribute. According to Harvard Health, frozen shoulder is most likely to affect people between the ages of 40 and 60, with a higher percentage of patients being women.
5. Poor posture, and other wear-and-tear conditions
Take note of how you’re sitting or standing right now. Is your posture perfect? Or is your body relaxed, but your bones and muscles unsupported?
Bad posture habits can cause your body to relieve pressure or strain and shift it to another location, like your neck. Over time, these temporary solutions can cause neck and shoulder pain. Fortunately, you can correct your posture through practice and ergonomic furniture that supports your body.
Likewise, any repetitive movements you do at work can lead to pain further down the road.
6. Spinal stenosis
Spinal stenosis is caused by a narrowing of the spinal canal, or the spaces between your spine. This occurs due to normal wear and tear or potentially osteoarthritis.
Stenosis can affect the discs of the neck (cervical stenosis) or the lower back (lumbar stenosis). It causes symptoms like:
- Localized pain, especially went standing upright
- Difficulty with balance or walking
- Numbness, weakness, or tingling in limbs and extremities
Although some people are born with naturally narrow spinal canals, the condition is usually attributed to:
- General wear and tear
- Spinal injuries
- Herniated discs
- Bone spurs (overgrown bones)
- Thickened ligaments
- Tumors, in rare cases
People over the age of 50 are most likely to develop spinal stenosis.
7. Pinched nerves (cervical radiculopathy)
Formally called cervical radiculopathy, a pinched nerve occurs due to degenerative factors that affect the discs in our spine as we age. These degenerative changes are often known as arthritis.
With time, our discus wear down, bulge, dry out, and stiffen as we grow older. This can cause discs to collapse and possibly turn into herniated discs. The extra stress can then interfere with a nearby nerve’s routine information transfer, effectively “pinching” it.
Some people who have pinched nerves and disc damage never feel any pain. For those who do, the sharp pain worsens with movement in their neck or shoulders. It can also be accompanied by a tingling in the fingers and hands and a numbness or lack of sensation in the area.
How to diagnose the cause of your neck and shoulder pain
If you’ve noticed pain in your neck or shoulder, tracking your symptoms can help a medical professional more accurately diagnose your condition.
Take note of some of the following characteristics of your pain:
- Can you point to when the pain started—gradually over time or suddenly?
- Does the pain feel better or worse at any particular time of day?
- Do you notice the pain comes with movement—or does it linger on as a dull ache?
- Is it difficult to stretch your neck or shoulder region because it feels tight and limited?
- Does a headache accompany your pain, particularly one that starts at the base of your skull?
- Have you experienced any numbness or loss of feeling in your arms, legs, or extremities (e.g. hands and feet)?
- Do you feel a tingling or “pins and needles” sensation in your arms, legs, or extremities?
- Has anything helped relieve your pain, such as hot or cold compresses, elevation, stretching, or over-the-counter medications?
If you decide to seek treatment for the pain, your doctor will likely run some diagnostic tests, which could include:
- Taking a history of your neck or shoulder pain and your symptoms
- Performing a physical examination
- Consulting your medical records and patient history
- Ordering diagnostic imaging tests, such as an X-ray of the affected region, electrocardiogram (ECG), CT scan (cat scan), MRI scan, or blood tests
Your doctor will be looking to identify the exact source and severity of your pain, as well as any other localized issues, in order to tailor your treatment program.
How do you relieve neck and shoulder pain?
The treatment for relieving your neck and shoulder pain is ultimately shaped by the cause of your pain. Always be sure to follow your doctor’s orders to ensure successful pain relief and healing.
Some neck and shoulder pain treatment can be done from home, while other methods should be performed with a medical provider. Neck and shoulder treatments include:
- Gentle stretching at home
- R.I.C.E. method (Rest, Ice, Compression, Elevation)
- Massage therapy
- Ergonomic changes at work and home
- Physical therapy
- Chiropractic care
- Epidural steroid injections
- Surgery for severe cases
Let’s look at these in more detail.
1. Gentle stretching at home
Your doctor may prescribe light stretching exercises you can do from the comfort of your own home to help with neck and shoulder pain. Always ask your doctor to demonstrate them for you so you follow proper technique.
Our lists of the 35 best neck pain exercises and more than 60 exercises for shoulder pain can get you started on guided movement to relieve neck and shoulder discomfort. However, always talk to your doctor before adding new stretches to your routine, as some could worsen your pain.
2. R.I.C.E. method (rest, ice, compression, elevation)
The R.I.C.E. method is a commonly prescribed first-line treatment for mild bone and soft tissue injuries, including some of the sprains and strains that cause neck and shoulder pain. Always check with your doctor first before using this method to make sure you didn’t get a more serious injury.
The R.I.C.E. treatment regimen gets its acronym from four steps:
- RestL Limit or avoid use of the injured area for 48 hours to reduce swelling and inflammation.
- Ice: Wrap ice (or a gel ice pack) on the affected area, with a barrier between your skin and the ice (e.g. from a towel or washcloth). Repeat four to eight times a day or, depending on the severity, as often as every hour, up to 20 minutes at a time.
- Compression: Use elastic bandages (e.g. ACE wraps), therapeutic boots, and slings to compress the area around the injury. Be careful not to compress too tightly: you want it to feel secure, but not throbbing, like a tourniquet in a blood test. If you have any doubts, consult your doctor first.
- Elevation: Elevate the injured area, ideally six to ten inches above your heart so your circulation will follow a downhill path.
This treatment is most effective if you use it immediately after an injury.
3. Massage therapy
A massage can help alleviate some of the discomfort caused by neck and shoulder pain.
A licensed massage therapist in your area (like a member of the American Massage Therapy Association) is trained to help safely rehabilitate your neck and shoulder muscles.
In a pinch? Try our instructions on how to do a self-massage for neck pain.
4. Ergonomic changes at work and home
From uncomfortable desk chairs at the office to too-comfortable sofas at home, our bodies get used to feeling at ease in our surroundings, even if that means poor posture.
Speak to your human resources or employee assistance program to see if they offer a complimentary ergonomic assessment for workers. Review our tips for relieving pain from “mouse shoulder” as well.
If your neck and shoulder pain is caused by poor posture, try these posture stretches from Harvard Health to relieve the aches that come from too much screen time whether you’re on the go or in your living room.
5. Physical therapy
Physical therapy can help alleviate some of the suffering that comes with neck and shoulder pain, depending on the cause of your pain.
A physical therapist will tailor a course of treatment for the affected area. Physical therapy happens in a setting like an outpatient center or fitness facility, and your therapist will personalize it to your limits and abilities. Their goals are to strengthen the muscles in an affected area, while also releasing tension.
6. Chiropractic care
Your doctor might also direct you to a chiropractor. These specialists are trained specifically in treating the spine and joints.
They’ll customize their treatments based on the description of your pain, notes from your doctor, and diagnostic exams.
7. Epidural steroid injections
Epidural steroid injections zero in on inflamed nerves. Patients who pursue this outpatient, non-surgical treatment often feel relief from their pain rapidly.
Sometimes epidural steroid injections for neck and shoulder pain could be administered over the course of a year. To learn more about this treatment approach, check out the following video.
8. Neck and shoulder pain medications
There are also medication options for treating neck and shoulder pain based on the cause of your pain. While some medications can be helpful for acute and mild cases of pain, others may help with moderate to severe pain after trying less invasive treatments and seeing no benefits.
A common first treatment is non-steroid anti-inflammatory drugs (NSAIDs) like naproxen (Aleve) and ibuprofen (Advil, Motrin). You can purchase this over the counter and use it for short-term relief.
Antidepressants, such as serotonin-and-norepinephrine reuptake inhibitors (SNRIs) and selective-serotonin reuptake inhibitors (SSRIs), can also help with neck pain.
Your doctor might also prescribe muscle relaxants and anticonvulsants for temporary relief while you recover or skin patches containing capsaicin.
For severe cases that haven’t responded to other treatments, surgery could be an option for some patients. The American Academy of Orthopaedic Surgeons provides an overview of spinal surgery options on their website.
To get expert treatment tailored to your neck or shoulder pain, click the button below to find a pain doctor near you or review our tips on finding a local pain specialist here.