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.
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
You may be able to ease neck and shoulder pain with some simple home treatments. Here are some strategies that can bring relief.
Hot and cold therapy
You can find treatments that may help with neck and shoulder pain in your freezer and medicine cabinet. If you just injured your neck or shoulder, try applying an ice pack or bag of frozen peas (wrapped in a towel to prevent frostbite) for about 15 minutes at a time, several times a day. That will help reduce inflammation and swelling that cause symptoms after an injury. After a few days, you may want to switch to heat therapy, which helps muscles loosen up and gets blood flowing to the injury site and promotes healing. A heating pad works well, though if you don’t have one, a hot towel or even a steamy shower can help. Avoid using heat if your neck or shoulder has obvious swelling.
Improve your posture
Good posture matters, since slouching and other bad habits can cause neck and shoulder pain, along with many other health issues. Improving your posture when you're at work and throughout the day can help relieve and prevent neck and shoulder pain. Here are some tips to help improve your posture problems.
Stand tall. Hold your head high, tuck in your chin, straighten your spine, throw your shoulders back, and pull in your belly. No matter your height, standing tall is great for your posture.
Avoid "tech neck." Surprisingly, a common cause of neck and shoulder pain may be in your pocket or on your desk. When you use a cellphone or computer, you may have a tendency to look down at the screen. As you slump forward, the weight of your head puts a lot of pressure on your neck and shoulders, which can make them sore and stiff. This problem has become so common that doctors have a name for it: tech neck. Adopting some good habits can help you avoid tech neck.
When you use your cellphone, try to hold the phone at eye level when viewing the screen. If you spend a lot of time on your phone all day, stretch your neck frequently.
When you’re working with a computer -- or whenever you sit for a long time -- making sure you’re in the proper seated position is important for preventing neck and shoulder pain.
- Sit up straight, with your hips, spine, and head in alignment.
- Tuck a small pillow behind your lower back if your chair lacks lumbar support.
- Keep your wrists straight and forearms parallel to the floor.
- Place your computer or laptop on a stand so that you don’t have to tilt your head downward to view the screen.
- Keep your feet flat on the floor and avoid crossing your legs.
- Take frequent breaks -- get up and walk around now and then.
Drive smart. Many of the same rules for healthy sitting apply when you get behind the wheel. Sit with your spine straight and use a small pillow or lumbar insert to support your lower back.
Work on your stress
When you feel stressed out, your neck muscles can naturally tense up, which worsens pain and other symptoms. You may also hunch your shoulders, which contributes to back pain. Psychological stress is bad for your body and mind in many other ways, so find a way to keep it under control that works for you. Some possibilities include:
Meditation. There are many forms of this ancient practice, which can focus and clear your mind.
Mindfulness. This practice involves closely observing what’s happening around you, without judgment, gently steering your attention back to your focus if your mind drifts off to other thoughts. Mindfulness meditation is popular, though you can also adopt a more mindful approach to everyday life.
Breathing exercises. Simply stopping to focus on your breath can help ease anxiety. Here's one widely used technique: Inhale through your nose for a count of four, hold it for a count of seven, then exhale through your mouth for eight counts. Repeat.
Practicing good sleep hygiene. Not getting a good night’s sleep can also impact your level of stress. Follow some good sleep hygiene habits to make sure you are getting plenty of shut-eye, including:
- Go to bed and get up at the same time every day.
- Cut back on caffeine if you think it’s keeping you up.
- Do something calming, like reading or taking a warm bath, before you go to bed.
- Avoid screens before bedtime.
- Don’t have a nightcap – it may make you drift off faster, but can mess up your sleep later on. Eating a big meal before bed is a no-no, too.
- Keep your bedroom dark and cool.
Get some exercise. Research shows that staying active can help relieve stress and anxiety. Find a workout or other activity (such as dance or gardening) you enjoy and stick with it.
Adjust your sleeping position
If you sleep on your back. It might seem like lying down should help relax your neck and shoulder pain, but sleeping in the wrong position can cause or worsen the problem. The worst position for your neck, shoulders, and back is sleeping on your stomach, which causes these body parts to become tense and stressed. Stomach sleepers are more likely than back or side sleepers to have neck pain during the day. Experts agree that sleeping on your side or back is much better for your neck.
If you sleep on your side. Most people sleep on their side. It’s important to keep your neck aligned with your spine while you snooze. A thin pillow will cause your head to droop toward the mattress and strain your neck, so the Sleep Foundation recommends using a thick pillow or a stack of them to keep your head in a neutral position. Just don’t stack the pillows too high or your neck could bend upward, and you don’t want that, either. You may also want to try rolling a towel into a tube shape and inserting it along the long bottom portion of your pillowcase, which can help support your neck. You can find special pillows with built-in neck support, too.
If you prefer to sleep on your back. If this is your favorite sleeping position, find a pillow height that keeps your head and spine aligned. Tuck a pillow under knees, which will take pressure off your lower back. You can also consider getting a feather-filled pillow, which is soft enough to conform to the shape of your head and neck. Or try a “memory foam” pillow, which does the same.
Neck and Shoulder Pain Treatment
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.
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.
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.
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.
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.
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.
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.
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.
Exercises for Neck and Shoulder Pain
Exercise is essential for preventing and relieving neck and shoulder pain. If you're being treated for pain and other symptoms in your neck or shoulder, ask your doctor what exercises are right for you. They may refer you to a physical therapist to learn the right technique.
Exercises for neck and shoulder pain fall into two categories: isotonic exercise, where you contract muscles while moving, and isometric exercise, in which you contract muscles without moving. Below are examples of each type. Remember to start slowly, don’t overdo it, and breathe regularly while doing these exercises.
Exercises for neck pain
1. While standing or seated, tuck your chin down to your chest, then turn your head to the right. Try to bring your chin close to the shoulder. Hold 3 seconds, return your head to the neutral position, then repeat with the left shoulder. Do this five times.
2. Bend your head as if you’re trying touch your right ear to your shoulder. Hold for a moment, return your head to neutral, then repeat with the other shoulder. Do this five times.
3. Place the palm of one hand on your forehead, then cover it with the other hand. Without moving your head, push it forward against your hand. Hold for a count of 10 and relax, then repeat three times. You can do a similar exercise by placing your hands at the back of the head and on each side with one hand.
Exercises for shoulder pain
1. Get a 1-pound or 2-pound weight and hold it in the hand of the arm with the painful shoulder. Lean forward and steady yourself with your good arm on the back of a chair or table. Let the arm holding the weight dangle with the elbow straight. Swing the weight side to side for 1 minute, then back and forth for 1 minute, then in a clockwise fashion with increasingly larger circles, then go counterclockwise.
2. Standing near a wall, hold out your arm straight and “walk” your fingers up it. Go as high as you can. When you reach as high as you can, turn your body slightly open and repeat. Do this until your side is facing the wall. Keep repeating the climbing motion for 10 minutes. Repeat several times a day.
3. Hold your arms out parallel to the ground, then place your palms together. Push the hands against one another for a count of five, relax, and repeat three times. For a related exercise, instead of placing your palms together, tuck the fingers of each hand into the other and pretend you’re trying to pull them apart.
When to See a Doctor for Neck and Shoulder Pain
Neck and shoulder pain often respond well to at-home treatments, but some cases need care by a doctor, and sometimes immediate treatment is needed.
Make an appointment to see your doctor if:
- You are using pain relievers, hot and cold therapy, and other treatments, but the pain is getting worse.
- You have had no luck with at-home treatments after several weeks.
- Your shoulder is red and numb, or you’re having a hard time moving it.
- You feel the pain scattering down your arms and legs.
- You have other symptoms, such as a headache or numbness.
Get to a doctor ASAP if:
- Your pain was caused by an accident, fall, or other form of trauma.
- Your limbs suddenly feel weak.
- You have a fever.
- Your head can go forward or backward much more than usual.
- You feel chest pain or pressure.
- Persistent swollen glands in your neck.
- You can’t control your bowels or bladder.
- You have suddenly become clumsy or keep falling.
Takeaways
Neck and shoulder pain are common problems with many potential causes, such as accidents, wear and tear, overdoing it when you work out, and even poor posture. Some simple steps can help prevent neck and shoulder pain, such as setting up your workspace so that it doesn’t stress your joints and muscles – even spending less time on your cellphone may help. You can relieve many cases of neck and shoulder pain with simple treatments such as an ice pack or heating pad, but if you develop chronic discomfort, see a doctor.
Neck and Shoulder Pain FAQs
What is the first line treatment for neck pain? If your neck pain is mild, you can usually manage it at home with simple treatments such as an ice pack or heating pad, or doing some stretching to ease the tension in your muscles. Practicing better posture by making certain adjustments like keeping your back well supported and your computer screen at eye level can help, too.
How to manage neck and shoulder pain? For mild neck and shoulder pain, often all you need to do is apply an ice pack or heating pad, pop some over-the-counter pain relievers, and take it easy for a few days -- many cases go away on their own after a short time. But if you have persistent or severe neck or shoulder pain, especially if it’s accompanied by other symptoms, see a doctor soon.
What is the best medicine for neck and shoulder pain? The best medicine for neck and shoulder pain is what works for you. No two cases are the same and these common problems have many potential causes. The right medicine for your will depend in large part on what is causing your aches and stiffness.
What is the best pain medication for shoulder pain? There is no single best medication for shoulder pain. Doctors often recommend ibuprofen, though some may suggest acetaminophen. If those don’t help, a doctor may prescribe other medication, such as muscle relaxers and certain antidepressants that can relieve pain.
