Understanding the cause of your shoulder pain is obviously crucial to figuring out how to treat it. So it’s vitally important to understand whether your shoulder pain is directly due to shoulder-specific tissue dysfunction, or whether it’s coming from somewhere else.

And in the case of this article, we need to know whether your shoulder pain is actually coming from your neck. After all, there’s no point obsessing over your shoulder-specific rehab if some relatively hidden neck dysfunction is causing your pain.

What is Neck-Related Shoulder Pain?

When discussing referred pain from the neck, we often think of a pinched nerve. And this can conjure images of nasty pain. But in reality, it can be much more subtle than this. We don't have to have a disc bulge compressing a nerve or an arthritic joint doing the same in order to experience pain somewhere else.

More often than not, neck-related shoulder pain can be a consequence of some relatively hidden joint or tissue restriction that has reached a "referral threshold". This threshold is the point where the tissue is overloaded enough to generate a pain signal somewhere else.<br><br>Interestingly, this referred pain may not come with any actual neck pain. Many assume that your neck has to be sore for it to refer. But unfortunately (for the purpose of a smooth diagnosis), this is not often the case. It's one of the reasons why referred pain and dysfunction can easily be overlooked if you're not paying attention.

So, in order to pick up on any neck issues, we need to focus on the type of pain you might be feeling.

Symptoms of Neck-Related Shoulder Pain

The main symptoms to look out for with neck-related shoulder pain are as follows:

- Vague, hard to localize pain or ache

We are talking shoulder pain you literally can't put your finger on. If it feels "deep" or a generalized area then it could be coming from your neck.

Classic symptoms like pins and needles, numbness, burning, etc can certainly be part of the conversation here. These may in fact suggest a nerve is getting impinged by a disc bulge or some joint dysfunction. However, these neck symptoms are commonly found down through the arm and into the hands and fingers and less around the shoulder area.

Where Does Neck-Related Shoulder Pain Come From?

When looking for the exact source of your neck-related shoulder pain, a great place to start is with what we call "Dermatomes".

As the image below highlights, dermatomes are sensory patterns linked to each spinal level. These dermatome distributions are formed during fetal development and play a huge role in uncovering any secret cause of your shoulder pain.

As you can hopefully see, the C4/5 levels are most commonly associated with the areas of most shoulder pain. So it's at these levels where we can expect to find any relevant neck-related dysfunction.

And for anyone unaware, the C4/5 levels are essentially right in the middle of your neck.

How To Self-Diagnose Neck-Related Shoulder Pain

Thankfully, there are some neat little self-diagnostic tools you can use to find any neck-related shoulder pain.

The first is to try some basic neck range of motions and see how it feels.

For example, if you turn your head right, left, up, down, or to either side and notice an increase (or decrease) in your shoulder symptoms, this could signal an important connection.

If you try the same movements and don't notice a change in your shoulder symptoms but DO notice extra stiffness or restriction in any direction, this could still be a subtle sign that your neck needs greater investigation.

And a great way to perform that investigation is with a tennis ball or lacrosse ball like the exercise in the video below

It's the same technique we discussed in our previous article on how to tell if your shoulder pain is first-rib related.

The idea is to take a lacrosse ball or tennis ball and do the following:

- Lie down or lean up against a wall.

- Gently place the ball just to the side of the bony bumps down the middle.

- Start at the very top under your skull, and eventually make your way down the neck - past those C4/5 levels, down to the base of your neck. We don't want to miss anything.

- Hunt around for any areas that feel stiff, tight, or dense. Then compare these findings to the other side.

Interestingly, one side usually feels MORE tight, restricted, and dense than the other.

When pressing in with the ball make sure to pay attention to what, if anything happens to your symptoms. If you hit a connected spot you may feel your shoulder pain increase or decrease.

This is important as it will tell you what level may be involved. By comparing both sides at this level you'll then know which side needs your attention the most and can help form the basis of a treatment plan going forward.<br><br>Better still, you can bring this information to us during your initial assessment and we can confirm your findings and integrate this into your rehab program!

How to Self-Treat Neck-Related Shoulder Pain

As mentioned above, the ball exercise makes for a brilliant treatment and self-diagnostic tool.

Following the same idea from above, you want to take the ball and let it press into any relevant areas you found during your self-assessment.

Obviously, it's more efficient to treat what you find as you find it, but it's also important to understand what you need to treat and what you can avoid.

In a perfect world, you want the areas that feel the stiffest and tightest to release - regardless of what side it's on and whether it is tender or not.

The reason behind this is that we don't want to view your issue as a left-sided issue or a right-sided issue. We want you to think of it as a NECK issue.

This means that if you currently have right-sided shoulder pain that is influenced by pressing the ball into that C4/5 area, but you actually feel more restricted on the LEFT side at the same level - you actually want to self-treat that left side. If you just push into the right side without it feeling overly stiff or restricted, then there's no guarantee your symptoms will improve if there's a strong handbrake on the other side.

Remember, in this instance, you're a neck, not just a left side or a right side. It's all physically connected. Don't forget that!

Many people will have stiffness on the same side as their symptoms, but it's important to double-check how the other side is going in case you miss something crucial.

Once you have a clear understanding of where your stiffness and tightness are you can get to work freeing things up and seeing how your symptoms respond.

Obviously, be respectful with your symptoms and use your common sense as to how hard and long you go for. If in doubt, make sure you have one of our Physical Therapists guide you through things.

Conclusion

At the end of the day, your neck has the potential to cause, or at the very least contribute to your shoulder pain. So it pays to take the time to either have us assess your neck or respectfully try it yourself at home.

Finding these hidden neck-handbrakes will go a long way to making sure your shoulder pain goes and stays away. Once resolved, there's just one more question to answer...

Why was your neck an issue in the first place? But we'll leave that story for another day!

In the meantime, why not come to the clinic for one of our FREE shoulder pain workshops? It's a great way to corner one of our therapists and learn a little more about what may have caused your pain and what can be done about it.

Registration is FREE and all it costs is your time and attention! Join us here!