Most patients who come to my clinic attend because of pain in their shoulder or arm. Sadly, shoulder pain isn’t limited to the shoulder and it is quite common for shoulder conditions to cause pain to radiate up to the neck or down the arm toward the elbow. Some patients have both shoulder and neck pain and it can be challenging for patients, phyios, GP’s and surgeons to work out if the problem is in the shoulder or the neck, or both. There are some tips that can help to identify if the neck is the problem.
Pain worsened by neck movements
If your pain is aggravated by movements of the neck then it is most likely that the problem is coming from the neck.
Pain shooting into wrist and hand
Shoulder pain can quite often radiate down the arm toward the elbow. When pain goes below the elbow down into the wrist or hand this can suggest that the problem may be due to a trapped nerve in the neck. When a nerve in irritated the brain feels pain in the distribution of the nerve not always at the site of irritation.
Shooting, electric, or burning pain
Most shoulder problems are musculoskeletal in nature (due to problems with bones, ligaments, tendons, or muscles). Musculoskeletal pain is often dull, and achy, or can be sharp, catching, or cramping due to muscle spasm. Nerve related pain is classically described as shooting, electric or burning pain often felt along the distribution of the nerve.
Pins and needles
Shoulder problems rarely cause “pins and needles” sensation. In rare instances acromioclavicular joint arthritis or frozen shoulder can cause pins and needs due to inflammation irritating nearby nerves. Pins and needles sensation is often due to compression, injury, or inflammation of sensory nerves. If the pins and needles are felt in both hands this is unlikely to be a shoulder problem. Pins and needles could suggest a neck problem but could also be due to systemic diseases such as diabetes, or nerve compression or injury elsewhere in the limb such as cubital or carpal tunnel syndrome.
Pain radiating to the face or scalp
Shoulder pain can cause pain radiating to the base of the neck. This is because most shoulder problems especially those that cause stiffness cause other muscles particularly the ones that control the shoulder blade to overwork and compensate for the other muscles around the shoulder. The trapezius muscle runs from the side and back of the neck to the shoulder blade. Spasm in this muscle can cause neck pain. However, neck pain that radiates up into the face or scalp is not caused from shoulder problems and is again most likely a result of nerve irritation in the face or upper neck.
If you are struggling with pain in your shoulder and neck its worth having it checked. We would take a thorough history of the problem, examine your shoulder and neck, and do the relevant tests and investigations to work out if the problem is in the shoulder, the neck or both. Having the right diagnosis is the key to working with you to determine the right treatment plan to get you on the road to recovery.