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Is your shoulder pain really coming from your shoulder?

This is a question we are often asking ourselves when evaluating a patient/client with complaints of pain around their shoulder or in their upper arm! Why? For starters, we can have referred pain throughout our body, which simply means that the symptoms you are experiencing in a given part of your body is actually caused by an injury/condition in another part of your body. The reasoning behind this is pretty complex, but essentially comes down to how our nervous system interacts with our muscles, bones, nerves, and connective tissue.

So if your shoulder pain isn’t coming from your shoulder, where else could it be coming from? Potentially your neck! There are many muscles that connect between your shoulders and neck, and the nerves that begin within your neck then travel around the shoulder and down the arm.

Here are some common symptoms/complaints of “shoulder pain” that really may be stemming from your neck!

  • Feeling like there’s a knot between your spine and shoulder blade

  • Burning or tightness between your spine and shoulder blade

  • Tingling along the top of your shoulder or the upper part of your arm

  • Pain around your shoulder plus tingling or numbness in your forearm/hand

If your pain is very localized to the tip of your shoulder, then chances are you are experiencing an injury that is truly something coming from your shoulder. However, we always always always double check our patients’ necks as we begin our exam. A very simple way you can begin to check for this yourself is by assessing your neck motion. If any of these movements reproduce your pain, the cause of your pain could very well be in your neck!

  • Flexion “chin to chest”

    • Feeling a little stretch through the back of your neck is pretty normal

  • Extension “look at the ceiling”

    • Feeling a little stretch through the front of your neck is pretty normal

  • Sidebend (or lateral flexion) “ear to shoulder”

    • Feeling a stretch on the opposite side of your neck/upper shoulder is okay

    • Does it feel a lot different side to side? Are you able to move a lot more to one side vs the other?

  • Rotation “look over your shoulder”

    • Feeling a little tight at the very end or a little stretch through the front of your neck/top of your shoulder is okay

    • Does it feel a lot different side to side? Are you able to move a lot more to one side vs the other?

Does everything seem normal? Cool! That is a great starting point for figuring out neck vs. shoulder, though there are certainly some other tests that we perform that really can’t be done to yourself.

Not sure? You can give these shoulder isometrics a try. All you need is a wall and/or doorframe to push into (so that it will resist you!), and the various directions bias different muscle groups around the shoulder.

Flexion: pushing into the wall in front of you, like you are trying to push it away

Abduction: pushing your entire forearm into the wall off to the side of your shoulder, like trying to push the wall away/lift your arm out to the side

External rotation: I tend to place just my hand/wrist against the wall. Push the backside of your hand/wrist into the wall, like you are pushing the wall away from you while still keeping your elbow tucked

Internal rotation: Placing your hand on the side of a wall/doorframe, like you are pulling the wall toward your stomach

Still not sure? Or did you find something that really reproduced your pain? Don’t sit there and deal with it, take action! Reach out to a trusted rehab provider - you can get in touch with us at 857-267-6033 :)


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