Pain felt in your shoulder area can sometimes be coming from your neck. Conversely, neck pain can actually be hiding a shoulder problem.
Why? Because the neck and shoulder muscles share the same densely packed nerve pathways. And when an injury occurs, your nerves don’t always tell your brain the correct location where your problem is located. When you feel pain in one part of your body that is actually caused by pain or injury in another part, it is known as “referred pain.”
Neck Pain Referred to the Shoulder
There are many nerves and muscles that arise from your neck that pass through your shoulder on the way down the arm. Referred neck pain is usually felt at the top of your shoulder over your trapezius muscle. When shoulder pain originates from an injury in the shoulder itself, it normally is felt over your upper arm.
However, further complicating diagnosis is that many who have neck-originating shoulder pain also develop weakness in their shoulder rotator cuff muscles along with shoulder bursitis. Thus, diagnosis often requires your musculoskeletal specialist to distinguish between these different two sources of pain.
Neck-referred shoulder pain can often be from your cervical spine neck joints and ligaments, or from a trapped nerve. The common causes of shoulder pain from the neck include:
- Spinal Osteoarthritis: a condition where disks narrow and bone spurs form.
- Spinal Stenosis: a narrowing of the space around the spinal cord, usually due to arthritis.
- Herniated Disk: when one of the cushioning disks between your spine’s vertebrae tear or leak
- Ligament or Muscle Injuries: frequently the result of a sports injury, fall or accident
Shoulder Pain Referred to the Neck
One of the sources of shoulder pain that can be referred to the neck can originate in the acromioclavicular, or AC joint. So let’s simplify that a bit.
The AC joint joins your collarbone, also known as your clavicle, with the acromion section of your shoulder blade (scapula). Just like it is for most parts in your body where bones meet, there is cartilage between the two bones – which is the tissue that allows the bones to move on each other. Think of it like Teflon smoothly allowing two ball bearings to rub against each other.
While the AC joint is vulnerable to many different kinds of injuries, the most common conditions are arthritis, fractures, and separations. And AC joint pain, as well as a number of other shoulder conditions, can radiate pain to the neck.
Figuring Out the True Source of Your Shoulder or Neck Pain
Your healthcare provider will start with a physical examination to diagnose referred neck or shoulder pain. They’ll also be looking to rule out other possible conditions. They may couple their initial examination with imaging (MRI, CT, Ultrasound, or X-rays) and blood tests.
Recommended treatments will vary depending on what they determine the underlying condition to be.