Neck & Shoulder Pain

The neck and shoulder are closely related anatomically, and it’s no surprise that they are intimately connected. Our busy lifestyles, which include driving, hunching over computers and electronic devices, and talking on the phone, can cause the muscles in the neck, upper back, and shoulders to tighten up and hurt at the same time. The question is, when it comes to pain in the neck and shoulder, which one is the chicken and which is the egg?

The neck is responsible for the nerves that innervate the head (C1-3 nerve roots), shoulders (C4-5), and arms (C5-T2). There are 8 sets of nerves in the neck, 12 sets in the thoracic (middle back region), 6 sets in the lumbar or low back region, and 5 sets in the sacrum. These nerves travel to specific destinations that allow us to move our muscles and feel hot, cold, sharp, vibration, and position sense. When these nerves get pinched or irritated, they lose their function and ability to feel. This can make it challenging to button a shirt, thread a needle, or pick up small objects. It can also make it difficult to unscrew jars, squeeze a spray bottle, or lift a milk container from the refrigerator. Hence, pinched nerves arising from the neck can have a dramatic effect on our ability to carry out our desired activities that require shoulder, arm, and hand use.

On the other hand, when the shoulder is injured (such as a rotator cuff tear), this can also result in neck problems. Pain information is relayed to the brain starting at the nerve endings located in the area of the shoulder injury. Impulses are transmitted between the shoulder and neck before finally reaching the sensory cortex of the brain. There are several ways pain from the neck affects the shoulder and vice versa.