For informational purposes only. Nothing in this article is intended as medical advice of any kind. If you feel you have a medical issue, you should seek the advice of a licensed Health Care Professional as soon as possible.
The neck and shoulders are made up of many bones, joints, muscles, tendons, veins, arteries, nerves and associated structures. They are all subject to injury, disease, and age. Neck and shoulder pain can be caused by injuries from accidents, overuse, or repetitive motions, degenerative diseases such as arthritis, spondylosis, and fibromyalgia, inflammation, infections, referred pain from other areas, or malfunctions such as pinched nerves, or compression of nerves and blood vessels.
Most neck and shoulder pain from injuries is from strains, tendinitis, and more rarely, torn tendons. The treatment for all of these is similar; RICE (Rest, Ice, Compression, and Elevation). Rest the injured area to give it time to heal, use ice packs on the affected area to reduce swelling and ease pain, use mild compression to stabilize the area, and keep the affected area above the level of the heart as much as possible. Strains usually improve within a week or so. Tendinitis may also require physical therapy and anti-inflammatory medications. Torn tendons are more serious and take a long time to heal. They may require surgery, and a long period of physical therapy to heal properly. Rotator cuff injuries can be especially problematic at night, because there are few ways to lay down to sleep without putting pressure on the injured muscles of the rotator cuff group. In addition to the other treatments, pillows may be required to stabilize the shoulder joint at night so that the patient can sleep.
Neck and shoulder pain resulting from disease is a different matter. Bursitis affects the liquid-filled sac (bursa) that cushions the shoulder joint. When the sac becomes inflamed, it causes excruciating pain. Mild cases will normally heal on their own with RICE, but more severe cases may require injections of steroids directly into the bursa. Recovery is usually complete. Arthritis is a degenerative disease affecting bones and joints, for which their is no cure. But it can be managed with medications, and various treatments. The actual cause of arthritis is unclear, but a joint or bone that has been injured has a higher risk of eventually becoming arthritic. Fibromyalgia is a central nervous system disorder that causes pain in joints and muscles. It also causes allodynia (a painful nerve stimulus that does not normally cause pain). The causes are not understood at this time, but it is believed that the brain changes the way it receives nerve signals, interpreting them as pain. It is not known if the change in brain function causes fibromyalgia, or is caused by it. There is no cure, but there are medications and treatments that help in managing the condition.
Nerves branch out from the spinal cord between the vertebrae and can sometimes become trapped between them, especially in the cervical (neck) and lumbar (lower back) areas, causing a pinched nerve. This results in pain. Treatment involves freeing the trapped nerve through direct manipulation, reducing inflammation, or in more serious cases caused by herniated discs or bone spurs, surgery may be required.
There are many other things that can cause neck and shoulder pain, but they should be diagnosed and treated by licensed medical specialists. Anytime you experience pain from an unknown cause, or it it persists, you should see your Primary Health Care Provider as soon as possible.