What does the pain in the shoulders and neck, the main causes

The cervicobrachial region in humans is the most mobile part of the musculoskeletal system, which is equipped with many bone-articular, ligamentous-muscular, nervous and circulatory plexuses. Therefore, it is possible that any inflammatory process as a result of neurological, mechanical or other damage can cause pain of varying degrees of pain in the shoulders, neck, and vital organs bordering them.

It is possible to establish the cause of pain and get rid of unpleasant symptoms with a timely visit to a doctor who will conduct a high-quality diagnosis and prescribe treatment. Consider the most likely clinical situations that provide a person with a pain reflex.

Cervicobrachial syndromes: causes, symptoms and treatment

Localized pain in the neck and shoulders can include a whole complex of various clinical manifestations that develop against the background of damage to the nerve roots of the neck and / or plexuses of the shoulder girdle, which often concern middle-aged or older patients.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Osteochondrosis or spondylosis

Degenerative-dystrophic transformations associated with the progressive development of cervical osteochondrosis can provide a pain reflex on the left side or emerging pain in the right shoulder and neck.

Neurological pathology is accompanied by deformation of the spinal bodies and the formation of bone growths on them – osteophytes:

  • a person is particularly sensitive in the form of acute, aching, pulling or boring pain syndromes after active physical activity;
  • pain from the cervical spine always gives in the shoulder girdle, forearm, sometimes in the upper limb;
  • upon palpation of paravertebral points, that is, places of exit of nerve trunks and blood vessels, pain is always felt.

In a diagnostic study, an x-ray shows a varying severity of signs of cervical osteochondrosis or another chronic disease – spondylosis, which causes similar pain.

Spondylosis of the cervical spine is the process of destruction of the cervical vertebrae as a result of their gradual wear, that is, physiological aging. Dystrophy of the outer fibers of the fibrous ring in the cervical region is associated with a violation of the activity of the endocrine glands.

Such clinical pathologies require medical treatment, especially in the acute stage. Therapeutic prophylaxis of cervical osteochondrosis and / or spondylosis – correctly placed power loads, that is, a special set of gymnastic exercises.

The pathology of cervical osteochondrosis is complicated by a hernia of the intervertebral disc when the pulpous contents in the vertebral body come out, tearing the fibrous ring. Projecting pains appear in the cervical-occipital region, radiating pain to the shoulder, arm and chest. The patient is constantly worried about headaches, increased arterial and intracranial pressure.


Along with compression damage to the nerve roots, another group of reflex neurodystrophic disorders is distinguished – the shoulder-shoulder periarthritis, which combines a group of various diseases of the periphery of the nervous system and musculoskeletal system.

According to the World Health Organization (WHO), shoulder-shoulder periarthritis affects almost a third of the world’s population.

A painful neurodystrophic disorder, still defined in neurology as “frozen shoulder” syndrome, is recognized by the following signs (see table).

Exacerbation stagePain in the left shoulder and neck, shoulder blades or on the right side occurs gradually and intensifies over time
The stage of “freezing”The increase in stiffness and limitation of mobility significantly reduces the amplitude of movements. Due to muscle tension, neck turns are painful or impossible
The defrost stageThe pain in the shoulders, neck and shoulder blades disappears, the range of motion increases, and the shoulder joint becomes malleable to stretching exercises

It is possible to achieve functional recovery of the cervical and shoulder body by introducing anti-inflammatory non-steroid drugs, physiotherapy and specially designed gymnastics for the shoulder joint.

Neuroma (schwannoma) of the spine

It happens that the pain between the neck and shoulder after a diagnostic examination confirms the presence of a benign tumor-like neoplasm in the brachial plexus trunk – a neurinoma growing from auxiliary cells of the nervous tissue (Schwann cells), the sizes of which range from a few millimeters to 5-8 centimeters.

Depending on the point localization of the neurinoma, when pressed on it, acute pain is felt with spreading to the shoulder and cervical zone.

Neuroma of the cervical region is excited (sore) after contact with the vertebral body during bending or turning the head. The exact location of the schwannoma can be determined using magnetic resonance imaging.

Treatment of the disease is not amenable to drug therapy and physiotherapeutic effects.

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The only way to get rid of the pathology is surgery, after which the prognosis for recovery will be favorable.


Depending on the localization, cervical or brachial plexitis is conditionally determined – a disease of the large nerve plexuses. A characteristic sign for a particular species is paroxysmal pain in the neck; gives to the shoulder with cervical plexitis, and with the shoulder – pain in the shoulder gives to the neck.

If the diaphragmatic nerve is involved in the inflammatory process with cervical plexitis, then a person begins a long hiccup, the act of breathing is disturbed. Brachial plexitis can be recognized by acute pain in the clavicle, muscle weakness of the shoulder muscles, some of their swelling and decreased sensitivity. The hand becomes lethargic, cold to the touch, the skin turns pale.

The causes of such a nervous disorder are infection, metabolic processes or trauma. Both medication and surgical treatment are provided for compression-ischemic genesis.

Myalgia (myositis)

If the pain symptoms – pain in the muscles of the neck and shoulders – do not stop even at rest, this is probably myalgia. Muscle pain is accompanied by redness of the affected areas, an increase in their temperature, nausea and vomiting reflex. Often, the patient has excessive sweating, headache and dizziness. When pressure is applied to the muscles of the neck or shoulder girdle, reflex irritation appears.

The causes of muscle disorder are metabolic disorders, hypothermia, infection of muscle areas (flu, tonsillitis). Other diseases of the vertebral system may be related to muscle inflammation:

Depending on the diagnosis and type of disease, an appropriate therapeutic treatment regimen is selected, which is supported by gymnastics, massage and physiotherapy. It is sometimes recommended to carry out home preventive treatment with folk remedies.

Shoulder and neck pain treatment

With any type of clinical pathology, the initial task is to eliminate the pain sign and remove the inflammatory process. Modern medicine has a sufficient arsenal of drugs to restore healthy health and ensure normal functioning of muscles and joints. Among the drugs of non-steroidal groups of anti-inflammatory action, if the pain in the shoulder girdle or neck is not associated with traumatic injury, we can distinguish:

  • Voltaren® acti (Voltaren® acti) is a tablet medicine that has anti-inflammatory, antipyretic and analgesic effects. The relief of pain and a decrease in temperature occurs within 15-20 minutes after taking the medicine. The drug is very effective for muscle cramps. Contraindications: ulcerative bleeding, renal or hepatic insufficiency, problematic clinic in the gastrointestinal tract, children under 14 years old, third trimester of pregnancy;
  • Aertal® (Airtal®) – a drug of the Spanish manufacturer, the company ALMIRALL SA It has analgesic and anti-inflammatory effects in various rheumatic lesions of the musculoskeletal system. Pharmacological action – elimination of stiffness and limitation of mobility, especially in the morning, reduction of swelling and / or swelling at the site of the lesion, improvement of the functionality of the muscular system and general condition of the patient. The dosage form is recommended for the symptomatic treatment of many neurological diseases of muscles and joints. Contraindications: gastrointestinal bleeding, erosive gastrointestinal tract lesions, childhood, pregnancy and / or lactation in women.

Among the pharmacological combinations of anti-inflammatory activity for external use, there are:

  • Amelotex® (Amelotex®) is a medicinal gel of the Russian manufacturer PharmFirma SOTEKS, which has an analgesic effect for joint and muscle pain in the neck and / or shoulders. The gel does not affect the progression of the disease, is a means of symptomatic therapy. Contraindications: skin diseases, hypersensitivity to the active ingredient – meloxicam;
  • Voltaren® emulgel (Voltaren® emulgel) – ointment for external use, its main active ingredient is Diclofenac®. The drug is intended to eliminate pain symptoms in the inflamed joints and muscles of traumatic or rheumatic origin. The only contraindication is allergic non-perception of the active substance.

It should be cautioned lovers of self-diagnosis and self-medication: improper dosage, improperly selected medication can aggravate clinical pathology and lead to the development of more serious complications, sometimes fatal.

Treatment with traditional medicine

We offer effective methods of home treatment with folk remedies for muscle pain in the neck and shoulder corset:

  • warming compress from vodka and horseradish leaves. The crushed leaves (2 tbsp. L.) Are poured with 100 ml of vodka or diluted alcohol. The tincture is aged for 1,5-2 hours. It is advisable to apply a home compress before bedtime;
  • very effective treatment of pain by burdock root. A glass of boiling water is taken on a tablespoon of dry raw materials. The healing product is infused for 1,5-2 hours and consumed inside an hour before meals;
  • to remove muscle spasm in the neck or shoulders will help a sheet of cabbage, applied at night.

It is advisable that any home activities be agreed with the attending physician or counseling specialist.

Secrets of physiotherapists

Pain in the shoulders and neck can occur not only with complicating pathological factors, but also after prolonged holding the head or back in an uncomfortable position – both standing and during physical labor.

You can alleviate your condition with the following therapeutic prophylaxis:

  • if the cause of the pain is immobility, then ice wrapped in a tissue or towel will effectively apply;
  • after the ice has relieved the pain, soothing warmth helps with a hot water bottle or hot shower. However, warming with a heating pad and warming ointments should not be used simultaneously;
  • a towel wrapped in a tourniquet wrapped around the lower back will create additional support for the back, while the pain in the neck and shoulder joints will be significantly reduced;
  • if your activity is entirely devoted to working at a computer, remember: the monitor screen should be at eye level. You need to form posture from an early age;
  • Before starting physical work, you should well knead and warm the muscles in the shoulders and neck;
  • the uniform must be suitable for the weather;
  • a good rest is important, which can be ensured with the help of an orthopedic mattress and pillow, purchased from a certified manufacturer;
  • salt intake should be limited;
  • give up alcohol, smoking and other unhealthy habits.

The main principle for the prevention of pain in the shoulders or neck is the development of the correct stereotype of movements both in everyday life and in the process of physical activity.

Massage procedures and special exercises for the neck and shoulder joints are very effective:

  • slowly tilt your head forward, and then, tilting it back, press it to the right shoulder. A similar movement is performed in the opposite direction;
  • slowly turn your head to the right, and then to the left side, trying to maximize the viewing angle with your eyes;
  • the right hand is firmly pressed to the back of the head, and the left – to the forehead. We begin to press with the left palm on the forehead, holding the neck with the right hand;
  • the right palm is on the temporal zone, and the left is fixing the neck. We do the enhanced movement of the palms towards each other. The exercise is repeated on the other side;
  • holding the ends of the towel behind the back of the head with your hands, it is necessary to deflect the head back with an effort of resistance.

Each exercise is performed 3-5 times a day. When performing preventive gymnastics, it is necessary to keep your back as even as possible, but without much stress.

The cervical complex of recreational gymnastics should be alternated with raising and lowering, turning in one and the other direction, mixing and breeding the shoulder body.

Following these recommendations of a healthy lifestyle, you can avoid unpleasant pain sensations not only in the shoulder and cervical body, but also significantly improve your general physical and moral condition.

Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles