People can develop neck and shoulder pain for a variety of reasons. In many cases, it may be a simple annoyance due to trauma or injury. Sometimes, it can indicate a serious condition, such as coronary artery disease.

In this article, we explore different causes of neck and shoulder pain. We also discuss treatment options and prevention strategies.

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Image credit: Reza Estakhrian / Getty Images.

Below are five potential causes of simultaneous neck and shoulder pain, along with suitable treatments.

Cervical spondylosis

People sometimes refer to cervical spondylosis as arthritis of the neck.

As people age, the disks and joints in the neck degenerate. More than 85% of people aged 60 and above experience cervical spondylosis.

The most common signs are neck pain and stiffness, but some people may not have any symptoms.

Other indications of cervical spondylosis include:

  • headache
  • a grinding or popping sensation when turning the neck
  • numbness and weakness in the hands, arms, or fingers
  • trouble walking
  • loss of balance
  • weakness in the legs
  • muscle spasms in the neck and shoulders

Treatment

Most people do not need surgery to treat cervical spondylosis. Treatment options include:

  • physical therapy
  • medication, such as acetaminophen, nonsteroidal anti-inflammatory drugs, or muscle relaxants
  • wearing a soft cervical collar
  • ice, heat, and other local therapies
  • steroid-based injections, such as a cervical epidural block, cervical facet joint block, or medial branch block
  • radiofrequency ablation

Subacromial bursitis

Subacromial bursitis is a common cause of shoulder pain.

Bursae are fluid sacs around the body’s joints that help lubricate and allow for movement. People with subacromial bursitis have inflammation in the sacs within the shoulder joint.

Doctors suggest that people often get this condition after repetitive overhead activities or trauma to the shoulder. Some people may also experience neck pain.

Treatment

As with cervical spondylosis, most treatments for subacromial bursitis are nonsurgical. These include:

Cervical radiculopathy

People usually refer to cervical radiculopathy as a pinched nerve. With this condition, the nerve root of a spinal nerve is squeezed or impaired.

Pinched nerve pain can spread far from the neck and may radiate to the:

  • arm
  • neck
  • chest
  • upper back
  • shoulders

In younger people, cervical radiculopathy occurs when the disks of cartilage between the vertebrae in the neck herniate or experience trauma.

In older people, cervical radiculopathy is usually a result of a degenerative condition.

Treatment

There is little evidence to suggest that surgery offers advantages over nonsurgical treatments. Doctors say that over 85% of acute cervical radiculopathy cases resolve without any treatment within 8–12 weeks.

However, nonsurgical therapies can help reduce inflammation of the nerve root. These include:

  • oral anti-inflammatory drugs
  • physical therapy
  • steroid injections along the spine

Sleeping position

Sometimes, people wake up with soreness in their neck, shoulder, or back.

There is no research that extensively studies the relationship between sleep posture and pain. However, people may want to modify their sleep posture to see if it helps reduce their neck pain.

Mattresses, pillows, and sleeping positions can all affect the strain on a person’s neck, shoulder, and spine as they sleep.

Treatment

There are no current guidelines to help people choose the most appropriate mattress and pillow to suit their sleep posture. Therefore, choosing these products may require some trial and error.

Coronary artery disease

People with sudden, unexplained neck and shoulder pain may be having a cardiac event, and they should seek emergency medical attention.

They may be experiencing angina, a common symptom of coronary artery disease, which triggers when blood supply is cut off from the heart. Pain from angina can feel like pressure or squeezing in the chest.

Some people may experience associated symptoms. These may occur in a different location on the body to the main symptoms.

For example, pain from angina may spread to the shoulders, arms, neck, jaw, or back. Sometimes, people may also have an upset stomach.

Treatment

Anyone who thinks they are experiencing angina should seek emergency medical attention.

People with a history of angina or coronary artery disease may have a nitroglycerin spray that can help relieve pain by rapidly dilating the blood vessels that supply the heart.

People who experience neck and shoulder pain from repetitive tasks should take a 5–10-minute break for every hour of work.

Exercises and stretches that people can do at their workstation include:

  • shoulder shrug
  • head glide
  • neck relaxer
  • shoulder roll
  • chest stretch

In a study published in the journal Pain, researchers looked at pain in more than 12,000 workers from 18 different countries. Most of these people were nurses, office workers, and other workers carrying out manual tasks with their arms.

The researchers found that pain localized in the neck was more common in workers who reported prolonged use of computer keyboards.

Localized shoulder pain was associated with occupations in which people elevated their arms for long periods of time.

Other studies mentioned by the researchers found that occupations in which people assumed uncomfortable postures and handled materials manually were associated with neck and shoulder pain.

Some awkward positions associated with pain include computer work and jobs in which people worked with their hands above shoulder height.

To prevent neck and shoulder pain at work, employers and employees should discuss ways to avoid neck and shoulder strain to ensure a safe working environment.

According to the National Safety Council, workplace injuries are preventable, and both employers and employees are responsible for workplace safety.

When people experience neck and shoulder pain with no apparent reason, they should see a doctor, who can examine the cause.

If over-the-counter pain medication is not effective, people can also speak with a medical professional for a diagnosis and treatment plan.

In those with simultaneous neck and shoulder pain, doctors may find it challenging to differentiate between a shoulder or neck issue.

In these cases, doctors will need to take a thorough medical history and complete a full physical examination. Some people may require medical imaging.

Other tools doctors may use to diagnose neck and shoulder pain include electromyography and selective nerve root injections.

Neck and shoulder pain may occur for a variety of reasons. This is why doctors can find it challenging to identify the cause.

Medical professionals need to conduct a thorough diagnosis to find the triggers for neck and shoulder pain. When they find the underlying issue, they can prescribe a treatment plan.

Some causes of neck and shoulder pain occur with age, whereas others may be related to trauma or repetitive workplace tasks.

In some situations, neck and shoulder pain may indicate a more serious condition, such as angina or a heart attack.

Anyone who experiences sudden unexplained neck and shoulder pain should seek emergency medical attention.