The neck and shoulders are prone to injury. Trauma, poor posture and arthritis are common causes of neck pain. Injuries include whiplash, tendonitis, fractures and dislocation of the shoulder. Treatments like physiotherapy, osteopathy or remedial massage can generally help neck and shoulder pain.
The head is supported by the neck, which is made up of seven bones (vertebrae) stacked one on top of the other. The vertebrae are cushioned by discs of cartilage and bound together with ligaments. Muscles provide movement and additional support. The neck is very mobile, which means it is less stable than other areas of the body and more susceptible to injury. Trauma, poor posture and degenerative diseases, such as arthritis, are the most common causes of neck pain.
The shoulder is a ball and socket joint with a large range of movement. Once again, a mobile joint tends to be more susceptible to injury. The shoulder joint relies heavily on the shoulder muscles for stability. Any dysfunction of these muscles or other anatomical structures, such as the collarbone, shoulder blade or joint itself, can cause pain and mobility problems.
Treatments like physiotherapy, osteopathy or remedial massage can generally help neck and shoulder pain.
An injury to the neck that results from a sudden jerking backwards and forwards is often called a whiplash. Typically, this occurs as a result of a rear-end motor vehicle accident. This type of injury can overstretch the neck and upper back region, resulting in a strain or tear to the supporting ligaments, muscles and discs, and even irritating the nerves.
Symptoms of whiplash
The common symptoms of a whiplash injury are pain, stiffness, dizziness and headache. Recovery depends on the individual and extent of the injury, but can take weeks to months.
Treatment for whiplash may include:
- Pain-killing medication
- Anti-inflammatory drugs or muscle relaxants
- Icepacks for three days
- Gentle mobilisation exercises
- Gentle soft-tissue mobilisation (massage)
- Immobilisation by wearing a cervical collar may help relieve the pain, but should only be used for a short time.
Torticollis (wry neck) or cervical dystonia
Torticollis is one of a group of involuntary muscle spasms (dystonias), which can affect various parts of the body. Writer’s cramp and spasm of the eyelid (blepharospasm) are other forms of dystonia.
Torticollis is a painful condition where contraction of the muscles in the neck causes the head to twist to one side. The spasms may persist so that the head becomes continuously twisted to the side. It may occur in children from a birth injury, but is most common in adults after the age of 40, when women are more commonly affected than men.
While some cases can be caused by injury, in most cases the cause is unknown. Your doctor may order certain tests to rule out any underlying cause, but generally, a diagnosis can be made from the history and clinical examination.
Treatment for torticollis
Treatment most often involves injections of botulinum toxin into the affected muscles, which paralyses the muscles and gives immediate relief. The effect of the injection does wear off and will need to be repeated every three to four months. Other treatments may include neck exercises, use of heat packs, reducing stress and getting rest breaks during the day to lie on your back.
Posture problems and neck pain
Poor posture can cause neck pain by putting extra strain on ligaments and muscles. Standing with the shoulders slouched and chin jutted forward, working with your head down for long periods of time, slumping while seated and sleeping face-down are common postural problems that affect the neck.
Suggestions on how to prevent posture-related neck pain include:
- Correct your posture when standing or sitting, adjust your pelvic position, lift your chest gently, nod your chin slightly and relax your shoulders.
- Ensure your workstation is set up to help you sit properly.
- Stretch and change position frequently while you are working.
- Try not to sleep on your stomach, which overextends your neck.
- Choose a urethane or down pillow for neck support while you sleep.
- Combat the muscle-tightening effects of stress with relaxation techniques.
- Exercise regularly to improve muscle tone and posture.
Osteoarthritis can affect the neck
Osteoarthritis is one of the most common types of arthritis. Anyone can be affected. However, since osteoarthritis is the result of altered usage of the joints of the body over prolonged periods of time, older people are particularly prone. Osteoarthritis is characterised by the breakdown of cartilage, the firm cushion found between two bones to stop them from grinding together.
Symptoms include pain, stiffness and muscle weakness. Commonly affected areas include the neck, lower back, hands, hip and knee. There is no cure for osteoarthritis, but it can be managed with exercise. Keeping the joint mobile and in its proper alignment are the best ways to improve the health of the cartilage.
If you experience shooting pains down your arm, or numbness or lack of power in your arm or hand, then you should see your doctor as you may need further tests, including x-rays, CT scans or an MRI.
Diagnosing the cause of shoulder pain involves assessing the degree of movement and strength in the joint, and possibly taking an x-ray and/or ultrasound. Some of the conditions that commonly cause shoulder pain include:
- Strains due to overexertion
- Tendonitis due to overuse
- Shoulder joint instability
- Collar or upper arm bone fractures
- ‘Frozen’ shoulder – pain and stiffness
- Pinched nerves.
Treatment for neck and shoulder pain
Neck and shoulder pain can generally be successfully treated with physiotherapy, although there are other options such as osteopathy or remedial massage to consider. If you need short-term pain relief from medication, it is advisable to talk to your doctor or pharmacist.
Treatment depends on the cause, but may include:
- Soft tissue massage
- Mobilisation to stretch tight muscles and other soft tissue structures
- Mobilisation or manipulation of the joint
- Specific exercise programs
- Taping to stabilise the shoulder joint
- Relaxation therapy
- Various treatments such as electrotherapy, heat, laser or ultrasound treatment
- Information on how to correct postural problems.
Where to get help
- Your doctor
- A physiotherapist
- Australian Physiotherapy Association Tel. (03) 9092 0888
Things to remember
- The neck and shoulder are highly mobile, which means they are also prone to injury.
- Trauma, poor posture and arthritis are common causes of neck pain.
- Some shoulder conditions that can cause pain include strains, tendonitis and fractures.
- Treatments like physiotherapy, osteopathy or remedial massage can generally help neck and shoulder pain.
You might also be interested in:
- Ankle sprains.
- Back pain - children.
- Back problems.
- Bone fractures.
- Elbow - common causes of pain.
- Knee injuries.
- Sprains and strains.
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Last reviewed: November 2012
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