• Dr. Mark Freund

What Is the Best Treatment for Neck and Shoulder Pain?


consulting patient for best treatment for neck and shoulder pain

Are you popping pain relievers for your neck and shoulder pain? Seek help and visit a chiropractor to identify the cause of your pain for corrective chiropractic treatment. Although taking medicines can give you immediate shoulder and neck pain relief, it does not address the cause of pain.


It should not be a surprise if you will still feel the pain after the medication wears off. Instead of relying on painkillers, visit your chiropractor or book an appointment for your corrective treatment. It would ensure that the cause of the pain was identified and corrected to prevent the pain from coming back. But how does chiropractic work?


Essentially, chiropractic treatment is manipulating the musculoskeletal system and not just addressing the pain in your neck and shoulder. It means that your joints, cartilage, bones, ligaments, tendons, and connective tissues are getting attention and care.


Hence, taking medications can relieve neck and shoulder pain, but the stress or injury in your musculoskeletal system is still present, which can even cause you pain. With this, chiropractic treatment ensures that your body and musculoskeletal system are cared for by locating the discomfort's source, especially your shoulders' discomfort. If you're searching for how to relieve shoulder and neck pain, you've come to the right place. In this article, we'll cover some of the best treatments for neck and shoulder pain.


Causes of Neck and Shoulder Pain

Most neck and shoulder pain is due to sprains and strains from sports, overexertion, or incorrect posture.


Soft tissue injuries

Neck and shoulder pain is often due to an injury of the soft tissue. Soft tissue includes your muscles, tendons, and ligaments. The term is used to distinguish it from the hard tissue of bones and cartilage. Soft tissue injuries can cause many kinds of pain, including:

chiropractor doing neck adjustment


Pinched nerve (cervical radiculopathy)

A pinched nerve in your neck can cause pain that radiates toward your shoulder. This is also known as cervical radiculopathy. Cervical radiculopathy most often comes from changes in your spine due to aging or injury.


Bone spurs can cause a pinching of the nerves that run through the hollow space in the vertebrae. If this happens in your neck, it can cause a pinched nerve. Symptoms include:


  • tingling or numbness in your fingers or hand

  • weakness in the muscles of your arm, shoulder, or hand


Rotator cuff tear

The rotator cuff is a group of four tendons that hold your upper arm (humerus) into your shoulder blade. A rotator cuff tear can be caused by a singular injury (such as a fall) or by repeated stress over time, which can be common in sports that require a lot of arm and shoulder use.


Aging can also contribute to rotator cuff tears. Reduced blood supply can slow down the body's natural ability to repair the damage. And bone spurs can form at the joint, damaging the rotator cuff tendons. A sudden tear will usually cause intense pain in shoulder to neck and immediate weakness in your upper arm.

Tears due to repetitive use may cause shoulder pain and arm weakness over time. Activities that require reaching up or behind, such as combing your hair, may become painful.


Whiplash

Whiplash is the tearing of muscles, tendons, and ligaments in your neck from a sudden movement of your neck. It typically occurs in an auto collision.

Other common causes include:


whiplash injury from car accident

contact sports

  • being shaken

  • falls

  • a blow to the head


Symptoms can take 24 hours or longer to appear and include:


  • neck pain and stiffness

  • headaches

  • dizziness

  • blurred vision

  • constant tiredness


Most people recover fully within three months, but some can have chronic pain and headaches for years afterward.


Stroke or cervical artery dissection

Neck pain can be a symptom of a serious type of stroke called cervical artery dissection. This condition is rare, but it's one of the most common causes of stroke in people under 50. Symptoms of a stroke include:


  • drooping of the face

  • arm numbness or weakness

  • difficulty speaking or slurred speech

  • vision trouble

  • difficulty walking


Herniated disc

When cervical discs shrink, vertebrae come closer together and can sometimes lead to one or more of the discs getting damaged. If the soft inner portion of a disc protrudes through its harder exterior, it's called a slipped, herniated, or prolapsed disc. Symptoms of a slipped or herniated disc include:


  • pain

  • numbness

  • tingling

  • aching

  • a burning sensation in your neck


Cervical spondylosis (cervical osteoarthritis)

Cervical spondylosis is the name given to age-related wear of the spinal discs of your neck. It's a very common condition, affecting more than 85 percent of people over age 60. Your spine is made up of bony segments known as vertebrae. In between each vertebra is soft material known as discs. As you age, your discs lose water content and become stiffer. Your vertebrae move closer together. This can irritate the lining of the joints in a condition known as cervical osteoarthritis. As part of arthritis, you can also develop bone spurs. Symptoms of cervical osteoarthritis typically include neck pain and stiffness. In more severe cases, it can lead to a pinched nerve.


Posture and sleeping position

Holding your neck in an awkward position for a prolonged time can lead to strains in the muscles and tendons of your neck and shoulders.

Some of the postures and activities that commonly contribute to neck and shoulder pain are:


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

  • grinding or clenching your teeth at night

  • sitting at a computer or over a phone with your neck strained forward or tilted up

  • suddenly jerking your neck during exercise


Stable angina

Pain in the shoulders, neck, back, or jaw can also be a symptom of stable angina. It occurs when the heart isn't getting enough oxygen due to a narrowing of the coronary arteries.

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 curved bone at the top of your chest that runs from your shoulder blades to your rib cage.

Clavicle fractures often happen when you fall on your outstretched arm.

Signs of a broken clavicle include:


  • intense pain

  • an inability to lift your arm

  • a sagging shoulder

  • bruising, swelling, and tenderness


Broken shoulder blade (scapula)

The shoulder blade (scapula) is the large, triangular bone that connects your upper arm to the collarbone. Scapula fractures can happen in high-impact injuries such as motorcycle or motor vehicle collisions. Symptoms include intense pain when you move your arm and swelling at the back of your shoulder.


Frozen shoulder (adhesive capsulitis)

Frozen shoulder is a condition where it becomes increasingly difficult and painful to move your shoulder. People between 40 and 60 years old and people with diabetes are at the greatest risk. The main symptom of a frozen shoulder is a dull or aching pain usually located over the outer shoulder and sometimes the upper arm.


Shoulder tendonitis or bursitis

Tendons are strong fibers that attach muscles to your bone. Bursa is fluid-filled sacs that prevent friction at joints. Inflammation of the tendons (tendinitis) and the bursa (bursitis) are common causes of shoulder pain, but pain can occur anywhere that inflammation occurs. The tendons and bursa around your rotator cuff are especially prone to inflammation that causes pain and stiffness around your shoulder.


Shoulder separation

A shoulder separation is an injury to the joint where the collarbone meets the highest point (acromion) of your shoulder blade. The joint is called the acromioclavicular (AC) joint.


Injury to the AC joint commonly happens when you fall directly on your shoulder. Severity can range from a minor sprain to a complete separation that shows a large bump or bulge above the shoulder.

Pain can occur in the surrounding areas.


Shoulder and neck referred pain

Because of the close connection of the nerves serving them, shoulder and neck pain is often mistaken for one another.

physical therapy for neck and shoulder pain relief

You may feel a pain in the shoulder that's actually coming from your neck, and vice versa. This is called referred pain.


Some of the symptoms of referred pain from your neck include:


  • stabbing, burning, or electric-like tingling pain

  • pain that radiates to your shoulder blade, elbow, and hand

  • pain that radiates down your arm when you twist your neck

  • pain that's relieved when you support your neck


Gallstones or enlarged gallbladder

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


  • sudden pain in your upper right abdomen

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

  • nausea or vomiting


Diagnosis

When you go to the healthcare provider complaining of shoulder and neck pain, expect a physical exam involving movement of the neck and shoulder so your healthcare provider can see what's causing your pain and gauge your range of motion. Then, you may be sent for imaging studies, which can include:


  • X-rays: To look at the bones and joints

  • Computed tomography (CT) scan: To examine the bone and spinal canal

  • Magnetic resonance imaging (MRI): To help identify herniated discs or pinched nerves

  • Electromyography (EMG) and nerve conduction studies: To identify nerve problems

  • Selective nerve root block: To try to pinpoint the source of nerve problems

  • Myelogram: To see the spinal canal and nerve roots18

  • Arthrogram with dye injection: To examine the shoulder joint

  • Arthroscopy (a surgical procedure using a camera): To evaluate soft-tissue damage


Treatments for Shoulder and Neck Pain

Most causes of neck pain are not life-threatening and resolve with time and conservative medical treatment. Determining a treatment strategy depends mainly on identifying the location and cause of the pain.


Although neck pain can be quite debilitating and painful, nonsurgical management can alleviate many symptoms. The doctor may prescribe medications to reduce the pain or inflammation and muscle relaxants to allow time for healing to occur.


Reducing physical activities or wearing a cervical collar may help provide support for the spine, reduce mobility and decrease pain and irritation. Trigger point injections, including corticosteroids, can temporarily relieve pain. Occasionally, epidural steroids may be recommended.


Conservative treatment options may continue for six to eight weeks. If the patient is experiencing any weakness or numbness in the arms or legs, seek medical attention immediately. If the patient has had any trauma and is now experiencing neck pain with weakness or numbness, urgent consultation with a neurosurgeon is recommended.


Stretching and Exercises

Neck and shoulder pain can happen as a result of musculoskeletal injuries, overuse, poor posture, nerve-related causes, and problems with the spine. The good news is there are stretches you can do to help improve flexibility, increase range of motion, and decrease pain and discomfort. In general, you can do most of these stretches daily, but pay attention to any discomfort. Remember, stretching should not hurt. If you have an acute or chronic neck or shoulder injury, you should consult with your doctor or physical therapist before starting any exercise program.


Neck Stretches

Neck stretches can help release tension at the top of the shoulders. To do a neck stretch:


  • Stand with the feet hip-width apart.

  • Let the arms hang down by the sides.

  • Look forward.

  • Tip the head to the right, trying to touch the right ear to the right shoulder.

  • Feel the stretch in the left side of the neck and shoulder.

  • Tip the head to the left, trying to touch the left ear to the left shoulder.

  • Feel the stretch in the right side of the neck and shoulder. Each time, hold the position for 10 seconds.

  • Repeat this three times on each side.


Shoulder Rolls

Shoulder rolls are an easy way to stretch the shoulders. To do shoulder rolls:


  • Stand with the feet hip-width apart.

  • Let the arms hang down at the sides of the body.

  • Breathe in and lift the shoulders up toward the ears.

  • Move the shoulders back, squeezing the shoulder blades together.

  • Exhale and drop the shoulders back.

  • Move the elbows forward, feeling the stretch at the back of the shoulders.

  • Repeat this ten times.


Cat Cow

This simple yet effective exercise is a multi-purpose exercise that works on several muscle groups, including muscles in the upper back, neck, and mid-back. To do this exercise, you have to take the stance of an animal on four legs.


  1. Crouch on your knees, your palms just underneath your shoulders.

  2. Now, raise your back just a bit. As if you are trying to form a convex semi-circle with your back. Do this while facing the ground.

  3. Then, sink your back by moving your neck backward so that your face points towards the ceiling. Exhale while doing this.

  4. Repeat a number of times and rest.

  5. Then start all over.


Arm Reach

All you need is a chair to perform this simple exercise. It can provide ample pain relief for neck and shoulder.


  1. Sit on this chair, looking ahead with both your feet on the ground. Try to put your feet close together and on the same plane.

  2. Now, without flexing or extending your elbows, raise your right arm over your head, reaching towards the right side of your body.

  3. Slowly, move the arm back to the start position.

  4. Do this a couple of times. Five times is just fine.

  5. Do the same thing with your left arm.

  6. Repeat as many times as you want.


Arm Scissors

This exercise works on the muscles of your shoulder and upper back. It is simple to perform yet very effective in offering shoulder pain relief. To perform this exercise:

  1. Stand erect, with your arms spread out like an airplane's wings.

  2. Your elbows should not be flexed or extended. The entire length of your arm should be straight and parallel to the ground.

  3. Now, move your arms towards one another and then underneath each other, as if they are some kind of scissors.

  4. Do this a couple of times.


If you want, especially if the exercise seems too easy for you and doesn't seem to be doing anything, you can hold some weight in your hands. But be careful not to hold too heavy material, so you don't cause any damage.


Heat/Ice Pack therapy

Cold therapy decreases the temperature of skin and muscle, which reduces blood flow and metabolic processes. This, in turn, reduces inflammation and swelling, helping reduce pain. Heat therapy, on the other hand, increases the temperature of skin and muscle, 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 amount of 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 that is associated with swelling and inflammation. It is most 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 that are affected by stiffness and tension—like sore or spasming muscles. Many find it helpful for neck, back, and shoulder pain especially, but it can also be used on other joints. But that doesn't mean they are mutually exclusive. You may find using them in combination with one another—using heat in the morning and ice at night—provides the most benefit.


Manual Therapy

Perhaps the best treatment for shoulder and neck pain is manual therapy or manual manipulation. Manual therapy can be helpful for the treatment of joints that lack adequate mobility and range of motion in certain musculoskeletal conditions. This limitation can cause discomfort, pain, and an alteration in function, posture, and movement. Manual physical therapy involves restoring mobility to stiff joints and reducing muscle tension in order to return the patient to more natural movement without pain. Thus, manual physical therapy may provide back pain relief both for patients with chronic back pain involving joint problems, such as sacroiliac joint dysfunction, and acute back pain from soft tissue injuries such as a back muscle strain or a pulled back ligament. Although extensive clinical studies have yet to be performed on all areas of manual therapy, limited clinical data and patient reports support the assertion that manual physical therapy can be effective in relieving back pain for certain patients.

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As a group, manual physical therapy techniques are aimed at relaxing tense back muscles and restricted joints in order to decrease back pain and increase flexibility. In general, manual physical therapy techniques employ the following types of movement:


  • Soft tissue work, including massage, which applies pressure to the soft tissues of the body, such as the muscles. This pressure can help relax muscles, increase circulation, break up scar tissue, and ease pain in the soft tissues.

  • Mobilization/manipulation uses measured movements of varying speed (slow to fast), force (gentle to forceful), and distances (called 'amplitude') to twist, pull, or push bones and joints into position. This can help loosen tight tissues around a joint, reduce pain in the joint and surrounding tissue, and help with flexibility and alignment.


Physical Therapy

There are several types of manipulations and exercises your physical therapist or chiropractor can use to relieve stiffness, strengthen the area, and restore normal function of the neck. Treatments for neck and shoulder pain such as cold or heat application, deep tissue massage, electrical stimulation, and ultrasound may be used prior to exercise.


During physical therapy, you will practice a range of exercises to stretch and strengthen the muscles that support your neck. You'll also learn how to improve your posture and range of motion. To help you learn proper postures, the physical therapist might have you stand in front of a mirror while exercising so that you can see your mistakes and correct them.


Traction

Cervical traction is a treatment often used in physical therapy to help treat neck pain and cervical radiculopathy (pinched nerves). It involves gently stretching your neck and separating the disc and joint surfaces in your cervical spine (neck). Cervical traction can be used for a variety of purposes.


  • It can be used to help decrease compressive forces in the neck, which can help take pressure off of the discs that reside between the vertebrae (spinal bones) in the neck.

  • It can also open up the spaces where nerves exit the spinal canal, which can help relieve pressure off of a compressed nerve.

  • Traction can also help stretch the muscles and joint structures around the neck.


This treatment can be applied in many different ways. Your PT can help you determine the best one. Options include:


  • Manual Cervical Traction: This type of traction is performed by your physical therapist, who holds your neck and head in his hands and then gently provides traction or pulling force to your neck. Rhythmic periods of pulling and resting are usually applied, with each position being held for up to 10 seconds.

  • Mechanical Cervical Traction: Mechanical traction for your neck involves using a harness that attaches to your head and neck while you're lying down on your back. The harness is attached to a machine that can provide a traction force, and the machine has a control panel so that your physical therapist can change the amount of force applied to your neck.

  • Over-the-Door Traction: This type of traction can be used at home and involves strapping a harness to your head and neck while you're sitting in a chair. The harness is attached to a rope that's strung through a pulley system over your door, and traction force is applied using weights, a sandbag, or a water bag that's attached to the opposite end of the rope.


Neck Immobilization

Short-term neck immobilization, such as with a soft neck collar, can help provide support and relieve pressure. The technique may have significant benefits for your joint injury recovery.


These benefits may include:


  • Reducing the levels of pain and discomfort from your injury

  • Increasing the range of motion of your joints

  • Improving the movement quality of your joints


Stress Reduction

Most physical therapists advise self-care for minor stress-related neck pain, including emotional coping strategies, dietary changes, and posture correction techniques. Taking an active role in neck pain treatment can help you get back to your routine more quickly. In the meantime, try one of these other highly effective neck pain relief methods before you call a doctor or chiropractor:


Get a Gentle Massage

One of the best ways to decrease the amount of pain in your neck is to massage the muscles that are most irritated. Letting someone else do the massaging for you can reduce the amount of strain experienced. Moreover, adding hot or cold compresses can provide quick relief during a tender rub down.


Stop the Unhealthy Habits

Smoking cigarettes may be harmful for obvious reasons, but drinking caffeine before bed may have some underlying effects you're unaware of. Pre-sleep stimulants can create undue tension in your nervous and musculoskeletal system, resulting in stress-related neck pain even if you're always in a good mood.


Ergonomics

Sitting or lying in certain positions may help the pain. For instance, someone who has a pinched nerve in the neck or low back might try curling into a fetal position or bending their neck or low back away from the pain, he says. Experiment with different standing or sitting positions until you find one that relieves some of that discomfort. Then, spend as much time in that position as you can.

neck and shoulder pain causes

Also, consider using a standing desk. These workstations pull double duty by forcing you out of a less than ideal sitting position and promoting more mobility and movement throughout the day. Standing and moving more often during the day is crucial to preventing and treating a pinched nerve in the torso or lower body.


If you work in an office and have a pinched nerve (or want to avoid one!), talk with your company's human resources department about modifying your desk so that you can stand while working. If you can't get an official standing desk, you might try turning your current desk into one by putting your laptop or computer monitor on a stack of books. Another option is to be diligent about getting up and taking a walk to the water cooler or bathroom each hour.


Reposition your keyboard. If your pinched nerve (or pain) is located in your wrist or forearm, consider adjusting the position of your keyboard. Ideally, your keyboard should be positioned so that your elbows are in line with your wrist. This means your wrists aren't reaching down or up to 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 it is 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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