Your neck and your shoulder are two different places, but sometimes pain in your shoulder can come from your neck. Nerves come from your spinal cord and feed the muscles in your arms. In addition to providing input into the muscles in your arms, these nerves also carry pain fibers and sensory fibers.

How can I tell where the pain is coming from?

Move your shoulder around. If your shoulder hurts more when you move it, the pain is most likely from your shoulder. If you move your shoulder around and there’s no change in your pain, then the pain may be coming from your neck.

If your neck doesn’t hurt but you have trouble moving it side to side, have trouble seeing to back your car up or to change lanes, it may also be because there’s something going on in your neck.

You may be able to press on your neck to see if there’s a specific tender spot that really hurts.

What’s the next step?

If you can’t figure out where the pain is coming from, make an appointment with one of the OrthoVirginia pain doctors, neck specialists or shoulder specialists. We're pretty expert at figuring out where pain is coming from.

You can also work with one of our physical therapists and they may be able to help.

Once your medical provider has diagnosed you, we have a variety of procedures to help neck and shoulder pain and we can choose the right treatment for you.

Frequently asked questions

How does a patient know when pain is bad enough to go to a doctor?

It varies per person. Some individuals are willing to wait to see if the pain persists and other individuals want to be seen right away. If you feel uncomfortable enough that you’re wondering if you should see a doctor, the answer is usually to see one.

If you suddenly start dropping things, you start feeling numbness go down your arm, or your muscles are getting week, those are red flags to see a doctor urgently.

If you have a problem with your neck that showed up on an MRI, what’s the next step?

Even if an MRI report says something is severe, it doesn’t necessarily mean that there is an emergency or something that needs to be treated. For some conditions, if you’re not having any pain, you don’t need to have treatment. Talk with the doctor who ordered the MRI to get more specifics.

Do you have suggestions of preventative measures to avoid neck and shoulder discomfort for people who work desk jobs?

Ask your company if you can get an ergonomic assessment of your workplace, either in an office or at home. Depending on your anatomy, you may have different needs.

Two common results:

  • Make sure that your computers are set up at eye level so you’re not having to bend your head down.
  • Look into a keyboard and mouse that are ergonomic or that mold to your hand.

A physical therapist can also give you specific exercises to help you at home.

Is there an upper age limit or a lower age limit on these pain treatments?

There is not an upper age limit on the treatments; I recently treated someone who was 104. There’s not a strict lower age limit, but we would not want to be doing these injections in teenagers or other young people unless there are extenuating circumstances.

Will physical therapy cure a pinched nerve?

Yes, often certain exercises and physical therapy treatments can make a pinched nerve feel better. Many patients I see are people who have tried physical therapy and it is not working well enough. There are plenty of people who I never see because the physical therapists get their pain better.

Pinched nerves send pain from the neck down the arms. What is the cause of pain going from the arm up to the neck?

A peripheral nerve can cause pain going from the arm up to the neck. For example, in carpal tunnel, pain tends to start in your fingers and goes backwards. When peripheral nerves are compressed, the compression is happening in another part of the body, not in the neck.

How soon do you start physical therapy after pain injections?

Physical therapy is not always needed, but when we think it would be beneficial having it start within one to two weeks of an injection is recommended. I get asked a lot if patients can have physical therapy the same day as an injection and yes, they can. I would never want to hold physical therapy for a procedure.