Arm & Shoulder Pain

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Neck and shoulder pain can be classified in many ways. Some people experience only neck pain or only shoulder pain, while others have pain in both areas.  Some people experience only neck pain or only shoulder pain, while others have pain in both areas. Poor posture and overexertion can cause pain in these areas, but at-home treatments like hot and cold therapy or over-the-counter pain medications can help relieve some symptoms. 

Neck Pain Causes

Causes of neck pain include:

• Abnormalities in the bone or joints

• Trauma

• Poor posture

• Degenerative diseases

• Tumors

• Muscle strain

Shoulder Pain Causes

The shoulder is a ball and socket joint with a large range of movement. Such a mobile joint tends to be more likely to be injured. Shoulder pain can stem from one or more of the following causes:

• Strains from overexertion

• Tendinitis from overuse

• Shoulder joint instability

• Dislocation

• Collar or upper arm bone fractures

• Frozen shoulder

• Pinched nerves (also called radiculopathy)

Diagnosing Neck and Shoulder Pain

• X-rays. Plain X-rays can reveal narrowing of the space between two spinal bones, arthritis-like diseases, tumors, slipped disks, narrowing of the spinal canal, fractures , and instability of the spinal column.

• MRI. Magnetic resonance imaging is a noninvasive procedure that can reveal the detail of neural (nerve-related) elements, as well as problems with the tendons and ligaments.

• Myelography/CT scanning. This is sometimes used as an alternative to MRI.

• Electrodiagnostic studies. Electromyography (EMG) and nerve conduction velocity (NCV) are sometimes used to diagnose neck and shoulder pain, arm pain, numbness and tingling.

Neck and Shoulder Pain Relief

There are many options for relieving neck and shoulder pain. Your doctor can tell you which is the best course of treatment for you.

Over-the-counter pain relievers. You may get some relief from neck and shoulder pain from anti-inflammatory medications such as ibuprofen or naproxen. Acetaminophen is another option. 

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Prescription medications. If you see a doctor about your neck and shoulder pain, they may prescribe drugs like muscle relaxers and even certain antidepressants, depending on the source of your pain. If arthritis is causing shoulder pain, corticosteroid injections may be helpful.

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Physical therapy. A physical therapist can teach you exercises to perform at home that can help relieve neck and shoulder pain, while also improving your flexibility. 

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Epidural Injections. An epidural is a type of pain-controlling injection that contains a combination of a numbing anesthetic and cortisone, a steroid. A provider injects the drug into the space around your spinal cord, called the epidural space. You’ll feel some immediate relief from the anesthetic, while the cortisone kicks in later in the week to decrease the inflammation and irritation causing your chronic pain.

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Immobilization for fractures. If you have shoulder pain related to a mild fracture, your doctor may recommend that you wear an arm sling or brace to immobilize the joint while it heals. If you suffer a neck fracture or other injury, you'll likely be instructed to wear a hard collar to keep your spine stable as it heals. Soft collars are also sometimes used to treat pain (such as from whiplash after a car accident), however they're somewhat controversial. Not all studies show that they help and some doctors worry that using them for too long can lead to trouble by causing muscles to weaken. 

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Transcutaneous electrical nerve stimulation (TENS). TENS is a treatment that uses a low current of electricity to relieve pain. However, a recent review found little solid evidence that it helps with neck pain. Likewise, another analysis failed to find clear evidence that TENS relieves pain from a common shoulder condition called rotator cuff tendinopathy. 

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Acupuncture. In this traditional Chinese treatment, a practitioner inserts slender needles into the body to treat pain and other conditions. One review found that acupuncture may provide some relief of neck pain, but the benefits were short lasting. Another recent review reached a similar conclusion for shoulder pain, finding that acupuncture may bring about short- to medium-term (less than 3 months) relief when used alone or in combination with other treatments. 

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Massage. A recent analysis found that massage offers little long-term relief, if any, for chronic neck pain. However, a neck and shoulder massage may relax tense muscles and make you feel more relaxed. 

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Surgery. If your neck and shoulder pain persist for months and nothing else eases your discomfort, your doctor may recommend surgery. Surgical repair of a condition such as a herniated disk in the neck or torn rotator cuff in the shoulder may be what it takes to get you back to being pain free.​​​​