Are You Having Shoulder Pain?
Or Is It Really Referred Neck Pain?
As a physical therapist I will see a patient for an initial evaluation for what they think is a shoulder problem. Very quickly during the evaluation I will discover that the root of the problem is coming from the neck and radiating pain into the shoulder.
How can this be the case?
How can you tell if your pain is coming from your shoulder or your neck?
For Starters...Here Are Some Of My Clues:
- Mechanism of Injury:
The mechanism of injury…or how your pain started, will always give a hint as to where the problem may have started. A grabbing, lifting, reaching, pulling motion of the shoulder that brought on shoulder pain may point the origin of the pain to the shoulder. But, for instance, if you turned your head quick or if you woke up with shoulder pain, then likely you didn’t strain something in your shoulder at night, and therefore it is probably coming from your neck either from bad positioning or something else during the day that started an issue in your neck that emerged through sleeping.
If you move your shoulder into full elevation, your arm behind your head, your arm behind your back, and across your chest, and you do not feel any increase in your existing pain, then likely the shoulder is not the source of the pain. But if you move your head and you find that looking, up or down, or side to side, or rotate left or right and you feel pain and limitation in movement, then your condition is emanating from your neck.
- Numbness and Tingling:
Shoulder conditions very rarely bring on numbness and tingling in the arm and hand. If you have numbness or tingling it could be from nerve compression in your neck. Persistent numbness and tingling is something to not ignore and you should seek treatment for this.
- Muscle Testing:
When I go through an evaluation, I will also check to see how strong and/or painful your shoulder muscles are when placed under stress, so I will muscle test them…or ask you to hold your arm in certain positions against my resistance. If you have weakness with pain with one or more of these tests, it will typically indicate a muscular issue in the arm and not an issue that is coming from the neck.
This is just a sampling of some of the bigger clues to differentiating a neck from a shoulder problem. There are also a number of special tests and further joint testing that may be part of the physical therapy evaluation process which can narrow the problem down even more.
If you think you are having a shoulder or neck problem and you can’t seem to get rid of it, no matter how much self-massage, anti-inflammatories, or modifying your activity level you do, please seek help.
My Discovery Sessions consist of a free 30-minute consultation to determine what the injury might be and whether it is appropriate for you to have physical therapy.
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