Your Shoulder Pain Might Actually Be a Neck Problem (And Why That's Good News)

So here's something that happens at least once a week in my clinic: someone comes in who's been dealing with shoulder pain for months. They've done the exercises. They've tried ice, heat, stretching, maybe even a cortisone shot. And nothing's really working.

Then I check their neck, and suddenly everything makes sense.

I know that sounds weird. "Doc, my shoulder hurts, why are you poking around my neck?" But stick with me here, because understanding this connection might be exactly what you need to finally get better.

The Neck-Shoulder Connection Nobody Talks About

Your neck and shoulder aren't separate systems, they're wired together. Literally. The nerves that control your shoulder and arm start up in your cervical spine, around the C5 and C6 vertebrae. When something goes wrong up there, maybe a joint gets stiff, muscles get tight, or a nerve gets irritated, you can feel it all the way down in your shoulder.

It's kind of like when your leg falls asleep because you've been sitting on it wrong. The problem isn't your leg. It's the pressure on the nerve higher up.

Dave's Story (Because This Actually Happens)

I had this patient, let's call him Dave, who'd been going to therapy for eight months. Eight months. All focused on his shoulder. Rotator cuff exercises, strengthening, manual therapy, the works. And sure, he'd get a little better for a few days, but then right back to square one.

When he came to see me, I spent the first session just evaluating. I'm moving his shoulder around, checking strength, range of motion. Everything looks... fine? A little weak, maybe, but nothing catastrophic.

Then I checked his neck.

I put a little pressure on his C5-C6 area and asked, "Does this feel familiar?"

His eyes got wide. "That's it. That's exactly where my shoulder pain is."

Bingo.

His shoulder wasn't the problem. His neck was referring pain down into the shoulder, and everyone had been chasing the wrong thing for months.

How We Actually Figure This Out

In PT, we call this finding a "comparable sign." Basically, I'm looking for something I can press, move, or mobilize that recreates what you're feeling. If I can reproduce your symptoms by working on a specific spot, there's a pretty good chance that spot is the actual source.

With Dave, gentle pressure and mobilization at C5-C6 lit up his shoulder pain every time. That told me we needed to stop hammering away at his shoulder and start addressing his neck.

This is why a thorough evaluation matters. You can waste months treating the wrong area if you don't dig deeper.

What We Did (And Why It Worked)

Once we knew the neck was the issue, treatment became way more straightforward:

Joint mobilizations on the cervical spine. Dave had some pretty significant stiffness in his neck, especially with rotation. We worked on restoring movement to those vertebrae, which took pressure off the nerves heading down to his shoulder.

Active Release Technique for the muscles. There were adhesions, basically, tight, stuck spots, in the muscles along his neck that were making everything worse. We worked through those carefully. Not too aggressive, because you can flare things up, but enough to get things moving again.

Strengthening after we got mobility back. This is key. Once we restored movement, we had to reinforce it. Dave's neck muscles had been weak and compensating for a long time. We needed to rebuild that foundation so the problem didn't just come right back.

Within a few weeks, his shoulder pain dropped significantly. By week six, he was basically pain-free and wondering why nobody had checked his neck eight months earlier.

Why Your Body Lies to You

Here's the thing about pain: it's a liar. Or, more accurately, it's not always a great detective.

Your brain knows something's wrong, and it knows roughly where the signal is coming from. But nerves travel, and pain can show up in weird places. This is especially true with nerve-related issues.

I've seen people with "elbow pain" that was actually coming from the neck. "Hip pain" that was really a back problem. Pain doesn't always show up where the problem is. That's why we have to do detective work.

What You Should Do If This Sounds Familiar

If you've been dealing with shoulder pain that just won't quit, especially if it's been months and you've already tried the usual stuff, consider getting your neck evaluated by someone who knows what they're looking for.

Does pressing on the side of your neck recreate shoulder pain? Does turning your head in certain directions make your shoulder ache? Those are hints that your neck might be involved.

And honestly? That's actually good news. Because if your shoulder isn't the problem, that means we haven't been treating the right thing yet. Which means there's still a lot we can do to help.

We Do This All the Time

This is literally what we specialize in, figuring out where pain is actually coming from, not just where it hurts. If you've been stuck, frustrated, and wondering why nothing's working, maybe it's time to look at things from a different angle.

Still dealing with stubborn shoulder pain?

Let's figure out what's really going on. I'm Dr. Rob Letizia, and we do this kind of diagnostic work every day at Spectrum Therapeutic of NJ.

Spectrum Therapeutic of NJ
601 Hamburg Turnpike, Suite 103
Wayne, NJ 07470

(973) 689-7123
spectrum@spectrumtherapynj.com
spectrumtherapynj.com

Give us a call. Let's actually fix this thing.