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Dr. Mark Freund

What Is the Best Treatment for Neck and Shoulder Pain?

Updated: Jul 26, 2022


consulting patient for best treatment for neck and shoulder pain

Are you taking painkillers for your neck or shoulder pain? Consult a chiropractor to find the root cause of your pain for corrective chiropractic treatment. While medication can provide immediate relief for shoulder and neck pain relief, it doesn't address the root cause.


It shouldn't surprise you that you may still feel the pain even after your medication has worn off. You should not rely on painkillers. Instead, consult your chiropractor or book an appointment to receive corrective treatment. This would allow you to identify the root cause of your pain and fix it to prevent it from occurring again. How does chiropractic work?


Chiropractic treatment involves manipulating the musculoskeletal systems and not just treating pain in the neck or shoulder. This means that your joints and cartilage, bones and ligaments, as well as the tendons and connective tissue, are receiving care and attention.


Although medications may relieve neck and shoulder pain, the stress or injury to your musculoskeletal systems can still be present, which can cause pain. Chiropractic treatment can help you to find the source of your discomfort, particularly your shoulders. This article will discuss the most effective treatments for neck and shoulder pain. This article will help you relieve neck and shoulder pain.


Causes of Neck and Shoulder Pain

Most neck and shoulder pain can be attributed to strains, injuries, and improper posture.


Soft tissue injuries

An injury to the soft tissue can often cause pain in the neck and shoulders. Your muscles, ligaments, and tendons are all considered soft tissue. Many types of pain can result from soft tissue injuries, including:

chiropractor doing neck adjustment


a pinched nerve (cervical radiculopathy)

Pinched nerves in the neck can invoke pain radiating towards your shoulder. This condition is also called cervical radiculopathy. Cervical radiculopathy is most commonly caused by spine changes resulting from injury or aging.


Bone spurs can pinch the nerves running through the vertebrae's hollow space. Pinched nerves can occur in the neck if this happens. These are the symptoms:

  • Tingling in your fingers and hands

  • Symptoms of weakness in your arm, shoulder, and hand muscle


Rotator cuff tear

The rotator wrist is a set of four tendons that connect your upper arm (humerus) to your shoulder blade. Rotator cuff tears are typically invoked by a single injury (such as a fall) or repeated stress, which is common in sports involving a lot of arms- and shoulder use.


Rotator cuff tears are also caused by aging. A blood supply can reduce the body's natural ability to recover and repair the damage. Bone spurs can form around a joint, causing damage to the rotator cuff tendons. A sudden tear can cause severe pain from the shoulder to the neck and weakness in your upper arms.

Tears from repetitive use can cause arm weakness and shoulder pain. It can be painful to perform tasks that require you to reach up or behind your head, such as combing your hair.


Whiplash

Whiplash refers to the sudden movement of your neck that causes tears in muscles, tendons, and ligaments. It is most common in auto accidents.


The following are other common causes:

whiplash injury from car accident

  • Contact sports

  • being shaken

  • falls

  • A blow to the head


It sometimes takes 24 hours for symptoms to manifest and could include:


  • Neck stiffness and pain

  • Headaches

  • dizziness

  • Blurred vision

  • constant tiredness


Most people can recover within three months. However, some may experience chronic pain or headaches for many years.


Stroke or cervical artery dissection

A cervical artery dissection is a serious form of stroke. Neck pain could be a sign of cervical artery dissection. Although it is uncommon, this condition is one of the most common causes of stroke among people younger than 50. The following symptoms characterize a stroke:

  • Drooping of the eyes

  • Arm weakness or numbness

  • Slurred or difficulty speaking

  • Vision problems

  • Difficulty in walking


Herniated disc

The shrinkage of cervical discs can cause vertebrae to become closer together, sometimes resulting in one or more discs being damaged. A slipped, herniated, or prolapsed disc is one in which the disc's soft inner part protrudes from its hard exterior. A herniated or slipped disc can be symptomatic by:

  • Pain

  • Numbness

  • Tingling

  • Aching

  • A burning sensation in your neck


Cervical spondylosis (cervical osteoarthritis)

Cervical spondylosis is the condition of age-related wear of the spinal discs of your neck. It's a common condition, affecting over 85 percent of people over age 60. Your spine is made up of bony segments called the vertebrae. In between each vertebra is a soft material, otherwise known as discs. As you age, your discs lose water content and stiffen. Your vertebrae move closer together. As part of arthritis, you can develop bone spurs. Symptoms of cervical osteoarthritis typically include neck stiffness. In severe cases, it'll lead to a pinched nerve.


Posture and sleeping position

Your neck can be held in an improper position for long periods, causing strains to the muscles in your neck and shoulders.


Some of the most common postures and activities can cause neck and shoulder pain.

  • Sleeping on a pillow too high or a stack of pillows

  • Nightly grinding or clenching of your teeth

  • Your neck should be bent forward when seated at a computer or on the phone.

  • During exercise, you may suddenly jerk your neck.


Stable angina

Stable angina can invoke pain in the neck, jaw, shoulders, back, and neck. This happens when the heart doesn't get enough oxygen because of a narrowing in the coronary arteries.


Usually, the pain is located in the middle of the chest. It can spread to the left arm, shoulders, neck, back, or jaw. It is crucial to have your health condition diagnosed and treated immediately.

neck and shoulder pain treatment-and-rehabilitation-after-injury

There's usually pain in the center of the chest, which can spread to the left arm, shoulders, neck, back, and jaw. It should be diagnosed and treated promptly.


Broken collarbone (clavicle)

The collarbone (clavicle) is the slightly curving bone at the top of your chest. It runs from your shoulder blades down to your rib cage. When you fall on your outstretched arms, clavicle fractures are common. A broken clavicle can be identified by:

  • Intense pain

  • Inability to raise your arm

  • A sagging shoulder

  • Tenderness, swelling, and bruising


Broken shoulder blade (scapula)

The shoulder blade (scapula) is the triangular, large bone connecting your upper arm and collarbone. High-impact injuries, such as vehicle collisions or motorcycle accidents can cause scapula fractures. Scapula fractures can cause severe pain in your arm, swelling around your back, and discomfort when you lift your arm.


Frozen shoulder (adhesive capsulitis)

Frozen shoulder is a condition that makes it more difficult and painful for your shoulder to move. The most at-risk are people between 40-60 years and those with diabetes. A frozen shoulder is most commonly characterized by dull, aching pains that are usually felt over the outer shoulder or upper arm.


Shoulder tendonitis or bursitis

Tendons attach bones to muscles using strong fibers called tendons. Bursa, a fluid-filled sac that prevents friction at joints, is called tendinitis. Bursitis and tendinitis, inflammation of the bursa and tendons around the rotator cuff, are two common causes of pain in the shoulder. However, pain can also occur wherever there is inflammation. Inflammation of the bursa and tendons surrounding your rotator cuff can cause pain and stiffness in your shoulder.


Shoulder separation

A shoulder injury is a shoulder joint separation between the collarbone and the shoulder blade's highest point (acromion).


Injury to the AC joint is common when you fall on your shoulder. The severity of an injury can vary from a mild sprain to severe damage that leaves a bulge or bump above the shoulder. It is possible to feel pain in the surroundings.



Shoulder and neck referred pain

Because they are so closely connected, neck and shoulder pain can often be mistakenly confused for each other.

physical therapy for neck and shoulder pain relief

Sometimes, you may feel pain in your shoulder that is coming from the neck. Referred pain is a feeling that radiates from the neck.

  • Stabbing, burning, and electric-like tingling pain

  • Pain radiating to your elbow, shoulder blade, and hand

  • When you twist your neck, it radiates pain down your arm.

  • Support your neck to relieve pain


Gallstones or enlarged gallbladder

Pain in your right shoulder can signify a gallstone blocking a duct in your gallbladder. You may feel pain in your back between your shoulder blades. The pain may be sudden and sharp. You may not feel the more common symptoms of gallstones or gallbladder inflammation. These are:

  • nausea or vomiting

  • pain in the center of your abdomen, below your breast bone

  • sudden pain in your upper right abdomen


Diagnosis

If you have neck or shoulder pain, your healthcare provider will perform a physical exam involving neck and shoulders movement. This allows your healthcare provider to determine the cause of your pain and your range of motion. You may then be sent to imaging examinations, including:


  • X-rays: To examine the bones and joints

  • Computed Tomography (CT scan): To inspect the bone and spinal canal

  • Magnetic resonance imaging (MRI): This detects herniated discs and pinched nerves

  • For the detection of nerve problems, electromyography (EMG) and nerve conduction studies are used.

  • Selective nerve root block: To pinpoint the root cause of nerve problems

  • Myelogram: To view the spinal canal and nerve root18

  • The shoulder joint can be examined using an arthrogram and dye injection

  • Arthroscopy: A surgical procedure that uses a camera to evaluate soft-tissue injuries.


Treatments for Shoulder and Neck Pain

Most neck pains are not serious and can be treated with conservative medical treatment. The first step in determining a treatment strategy is to identify the cause and location of the pain.


Neck pain can sometimes be debilitating and can cause severe discomfort. Nonsurgical treatment can help to relieve many of the symptoms. The doctor might prescribe drugs to ease the pain, inflammation, and muscle relaxants to speed healing.


A cervical collar or reducing physical activity can help support the spine, decrease mobility, and reduce pain and irritation. Temporarily relieving pain can be achieved by using trigger point injections (including corticosteroids). Sometimes, epidural steroids might be recommended.


The conservative treatment options can be continued for six to eight weeks. Seek medical attention immediately if the patient feels any weakness or numbness in their arms or legs. A neurosurgeon should be consulted immediately if the patient has suffered trauma and is experiencing neck pain, weakness, or numbness.



Stretching and Exercises

Musculoskeletal injuries, poor posture, nerve-related problems, and neck and shoulder pain are all possible causes. You can do many stretches to increase flexibility and range of motion, decrease pain and reduce discomfort. You can generally do most of these stretches daily, but be aware of any discomfort. Stretching should not cause pain. Before you start any routine exercise program, consult your physician if you have a chronic or acute injury to the neck or shoulder.


Neck Stretches

Neck stretches can be used to release tension from the top of your shoulders. To do a neck stretch:


  • Place your feet hip-width apart.

  • Take a look ahead.

  • To touch the right shoulder, tilt your head to the left.

  • You can feel the stretch throughout the left side of your body

  • Try to tip your head to the right, aiming to touch the left ear with the left shoulder.

  • The right side of your neck and shoulder should feel the stretch. Hold the position for 10 seconds each time.

  • Repeat the process three times per side.


Shoulder Rolls

Shoulder rolls are one way to stretch your shoulders. To do shoulder rolls:

  • Place your feet hip-width apart.

  • Breathe in, and raise your shoulders towards the ears.

  • You can move your shoulders back by squeezing the shoulder blades together.

  • Inhale deeply and lower your shoulders.

  • Feel the stretch in your shoulders by moving your elbows forward.

  • Repeat this ten times


Cat Cow

This easy yet powerful exercise targets multiple muscle groups. It includes the muscles of the neck, upper back, and mid-back. You will need to assume the position of an animal on your four legs to do this exercise.


  1. Place your hands below your shoulders, and crouch on your knees.

  2. Now raise your back a little. Now, raise your back a bit. Face the ground.

  3. Next, lower your back and move your neck backward so your face is towards the ceiling. While doing this, exhale.

  4. Continue this process a few more times before you stop.

  5. Start over.


Arm Reach

To perform this simple task, all you need is a seat. This can offer pain relief for the neck and shoulders.


  1. Sit on this chair and look ahead, keeping your feet on the ground.

  2. Now, extend your elbows without flexing.

  3. Slowly move your arm back to its original position.

  4. This can be done a few times. It's fine to do this five times.

  5. Repeat the process with your left arm.


Arm Scissors

This exercise targets the upper back and muscles of your shoulder. This exercise is easy to do, but it provides shoulder pain relief. This exercise is easy to do:


  1. With your arms outstretched like an airplane's wings, stand straight up.

  2. Your elbows shouldn't be extended or flexed. Your arm should run straight and parallel to the ground.

  3. Bring your arms together and place them underneath one another as if you were using scissors.

  4. This can be done several times.


You can hold a dumbbell in your hands during this exercise, especially if it's too easy.


Heat/Ice Pack therapy

Cold therapy decreases skin and muscle temperature, reducing blood flow and metabolic processes. This, in turn, reduces inflammation and swelling, helping reduce pain. Heat therapy, on the other hand, increases skin and muscle temperature, along with blood flow and metabolic processes. This improves healing and elasticity, thereby helping reduce pain.

Whether you choose hot or cold therapy for pain, there are many different delivery methods.


Each has pros and cons related to efficacy and convenience. Common types of heat therapy include:

  • · Topical gels or creams with compounds like capsaicin

  • · Powered heating pads, blankets, or wraps (sometimes portable)

  • · Hot baths, showers, hot tubs, and saunas

  • · Physical therapy-based heat, like ultrasound


Heat therapy options can also be categorized as moist or dry heat—you may find one or the other is more useful depending on your type of pain. Dry heat includes things like heating pads and even some saunas. Moist heat involves heat combined with moisture, like steamed towels or hot baths.


Delivery methods for cold therapy for chronic pain include:


  • Topical gels or creams with compounds like menthol

  • Ice packs or wraps

  • Cold or ice baths or showers

  • Cryotherapy


Cryotherapy is a newer option but is increasingly popular. It involves spending a short time in a freezing or near-freezing chamber.


When to use heat or cold therapy for chronic pain

Cold therapy is typically recommended for pain associated with swelling and inflammation. It is often useful for painful joints, including knees, shoulders, and elbows.

frozen shoulder treatment using cold compress

Hot therapy, on the other hand, is best for areas affected by stiffness and tension—like sore or spasming muscles. Many find it helpful for neck, back, and shoulder pain, but it can also be used on other joints. You may find using them in combination with one another—using heat in the morning and ice at night—provides the most benefit. But that doesn't mean they are mutually exclusive.


Manual therapy, or manual manipulation, is the best treatment for neck and shoulder pain. Manual therapy is a good option for treating joints with limited mobility or range of motion due to certain musculoskeletal conditions. This can lead to pain, discomfort, altered function, posture, or movement. Manual physical therapy is a method of restoring mobility and decreasing muscle tension to allow the patient to move more naturally without experiencing pain. Manual physical therapy can provide back pain relief for chronic back pain, such as those caused by joint problems like sacroiliac dysfunction, as well as acute back pain due to soft tissue injuries. While no clinical studies have been done on every aspect of manual therapy, limited patient reports and clinical data support the claim that manual physical therapy is effective in relieving back discomfort for some patients.


Manual physical therapy techniques, as a whole, are designed to relax tight back muscles and restricted joints and decrease back pain. Manual physical therapy uses the following movements:


  • Soft tissue work is a technique that applies pressure to the soft tissues, such as the muscles of the body. The pressure can relax muscles, increase circulation and reduce pain in the soft tissue.

  • Mobilization/manipulation utilizes measured movements of varying speed from slow to fast, gentle to forceful, and distances to twist, pull, or push bones and joints into position. This can loosen the tissues surrounding a joint and reduce pain. It also helps with flexibility and alignment.


Your chiropractor or physical therapist can perform a variety of manipulations to help relieve stiffness, strengthen the area and restore normal function. Neck and shoulder pain treatments may include cold and heat application, deep tissue massages, electrical stimulation, and ultrasound.


You'll be able to do various exercises during physical therapy that stretches and strengthens your neck muscles. The physical therapist may ask you to stand in front of a mirror during exercise so you can correct your mistakes.


Traction

Cervical traction (or cervical radiculopathy) is a treatment that can be used to treat neck pain, pinched nerves, and neck pain. This involves gently stretching your neck and separating your cervical disc and the joint surfaces of your cervical spine (neck). There are many uses for cervical traction.


  • It can be used to reduce compressive forces in your neck. This can help relieve pressure on the discs between your neck vertebrae (spinal bone).

  • It can also help relieve pressure on a compressed nerve by pressing it.

  • The muscles and joints around the neck can be stretched by using friction.


You can apply this treatment in many ways. Your PT will help you choose the right one. There are many options:


  • Manual Cervical Traction: This is where your physical therapist holds your neck and head and applies gentle pulling or traction to your neck. Each position is held for 10 seconds.

  • Mechanical Cervical Traction: A harness is attached to your neck and head while lying down on your back. The harness attaches to a machine that can apply a traction force to your neck. A control panel allows your physical therapist to adjust the force.

  • Over-the-Door Traction is a type of traction that can be used at home. It involves attaching a harness to your neck and head while you sit in a chair. Attach the harness to a rope and pull it through your door. Then apply traction force using weights, a bag, or a waterbag attached to the other end of the rope.


Neck Immobilization

A soft neck collar supports the neck and temporarily reduces pressure. This technique could be very beneficial for joint injury recovery.


These benefits could include:

  • Reduce the discomfort caused by your injury

  • Increase your joint's range of motion

  • Improve the movement quality in your joints


Stress Reduction

You can return to your regular life faster by taking an active part in neck pain treatment. Many physical therapists recommend self-care for minor stress-related neck problems, such as emotional coping strategies and dietary changes. Before you call your doctor or chiropractor, consider these other effective methods for neck pain relief.


Get a Gentle Massage

Massage the most painful parts of your neck to reduce pain. You can decrease the strain by having someone else massage your neck. Hot or cold compresses are a quick way to relieve tension after a tender rubdown.


Stop the Unhealthy Habits

Although smoking cigarettes is harmful, caffeine before bed could have other side effects. Even if you are in a positive mood, pre-sleep stimulants can cause undue tension in the nervous and musculoskeletal systems. This can lead to stress-related neck pain.


Ergonomics

The pain may be relieved by lying down or sitting in certain positions. He suggests that someone with a pinched nerve in their neck or low back might try to curl into a fetal position or bend their neck or lower back to relieve the pain. You can try different sitting and standing positions until you find the one that helps. Spend as much time as possible in this position.

neck and shoulder pain causes

Also, consider using a standing desk. This doubles as a workstation that forces you to move around the office and encourages mobility. Moving around frequently during the day is important to prevent and treat a pinched nerve in your torso or lower back.


If you are a worker in an office and feel like you have a pinched nerve or want to avoid it, there are ways to get help. Talk to your human resources department to discuss changing your desk so you can stand while you work. You can also make your desk a standing desk by placing your computer monitor or laptop on a stack. You can also be more active and walk to the bathroom or water cooler every hour.


Reposition your keyboard. Adjust the position of your keyboard if you feel pain or a pinched nerve. Your keyboard should be placed so that your elbows meet your wrist. This ensures that your wrists don't reach down or up when you type.


Pain Management for Neck and Shoulder Pain

At Natural Care Chiropractic, our chiropractors have extensive experience in mitigating, relieving, and managing long-term and chronic pain. Our chiropractic services can help increase mobility, ease stiffness and soreness and reduce pain, whether concentrated in your back, neck, joints or elsewhere. Contact our chiropractors today to learn how we can help you relieve your pain, wherever it appears in your body.

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