What is Neck Pain?

Pain in the neck and shoulder area can be caused by several diseases. Some individuals can have only neck pain or only shoulder pain, while others may complaint of pain in both the areas. The neck and shoulders have several muscles, bones, nerves, arteries, veins, ligaments and other supporting structures.

Causes

• Injury: The commonest cause of shoulder and neck pain is injury. The injury can involve the soft tissues such as the muscles, tendons, and ligaments within these structures.
• Arthritis: Arthritis of the spine in the neck (cervical spine) can compress the nerves and cause neck and shoulder pain.
• Degenerative diseases: Degenerative diseases of the disc in the neck (cervical spondylosis) can cause local neck pain and if the nerve is compressed it can cause shoulder pain as well.
• Tumors, muscle strain, poor posture, overexertion

Symptoms

• Pain: Your pain can vary in character from being sharp, to dull, burning, crampy, shocklike, or stabbing. Pain can cause stiff neck or shoulder, headache and even loss of range of motion.
• Weakness: Severe pain from muscle or bone movement can cause reluctance to move the shoulder and weakness of the shoulder.
• Numbness: If the arthritis or degenerative disease of the disc compresses the nerve you may have pain or numb feeling, burning sensation, a loss of sensation, or an altered sensation. 
• Swelling: Injury to the neck or shoulder may cause pain, deformity and swelling of the shoulder and arm.

Tests and Diagnosis

Diagnosing the exact cause of your neck and shoulder pain can be difficult at times owing to a wide range of possible causes. Your doctor will take a complete medical history and do a thorough physical exam to diagnose the underlying condition. Medical history may include questions regarding location of the pain, time and pattern of the pain, history of injury and any other associated symptoms such as numbness, feeling cold in the hand.

Diagnostic tests that may be performed to diagnose the underlying cause of pain include:

• CT Scan: CT scan can show the above mentioned findings such as narrowing of the space between two spinal bones, arthritis-like diseases, tumors, slipped discs, narrowing of the spinal canal, fractures and instability of the spinal column that are not obvious on an X-ray. This is often done as an alternative to MRI.

• MRI: Magnetic resonance imaging shows the details of neural (nerve-related) elements that are not visualized on CT scan.

• Myelography: Done as an alternative to MRI

• ECG: An electrocardiogram may be needed if you complaint of chest pain, shortness of breath, and have risk factors for a heart attack (such as high blood pressure, diabetes, high cholesterol, or tobacco use).

Treatment

Your doctor will prepare a treatment plan after a complete history and physical examination (and any tests, if indicated). Treatment of all the underlying causes cannot be detailed here as the treatment for a simple strain is far different from treatment of heart attack. The appropriate treatment to relieve pain that may be helpful in all the conditions is given below.  If you have a minor injury, sprain or strain, then a combination of the following treatments may be helpful.

• Rest: This is most important after injury, sprain or strain. Do not overexert and take rest as this allows the acute inflammation and pain to subside.