See instructions for pain relieving exercises.

neck-and-shouldersThe incidence of neck and shoulder pain is prevalent across a variety of demographics throughout the population. The goal of this article is to provide practical information regarding neck and shoulder pain including simple treatment strategies as well as advice regarding when to seek medical attention. In order to accomplish these goals, we will review the function of the spine and shoulder as well as some common pathologies. Finally, we will explore how to treat and prevent neck and shoulder pain through the use of therapeutic exercise.

The spine and shoulder each have several important functions that are essential for both efficient and pain free movement as well as optimal performance. The spine serves to establish our posture, provide an attachment site for many different muscles including the trapezius, rhomboids, and latissimus dorsi. The spine also aides in force transmission between the upper and lower body, in addition to protecting the spinal cord.  Similarly, the cervical spine or neck has the additional important function of supporting the weight of our skull. Additionally, the shoulder complex is a series of joints throughout the upper body and trunk including the scapulothoracic joint, sternoclavicular joint, acromioclavicular joint and glenohumeral joint that work together to provide us with an extensive amount of range of motion at our shoulders which increases our ability to manipulate objects in our environment.   

Unfortunately, many people suffer from several common pathologies that can cause either neck or shoulder pain or in some cases, both neck and shoulder pain. Common pathologies of the neck include spinal stenosis, cervical spondylosis, spondylolysis and spondylolisthesis, as well as intervertebral disc disorders. While each of these pathologies has a unique etiology and can present in a somewhat different manner, the end result is often neck pain and stiffness.  Similarly, common pathologies of the shoulder complex include subacromial impingement syndrome, rotator cuff tears, labral tears, as well as osteoarthritis. Each of these pathologies tends to have more of an insidious onset, but in the case of rotator cuff and labral tears, can also be the result of a traumatic injury.

Many people dealing with neck and shoulder pain are often unsure as to when to seek medical attention for their issues. In general, if you notice sensory changes in the arm, hand or fingers such as numbness or tingling, motor changes such as weakness in the shoulder, elbow, wrist, or hand, or decreased shoulder or neck range of motion, then it is important to see your doctor for a referral to an orthopedist in order to get an accurate diagnosis as well as a plan of care going forward. Similarly, the presence of systemic symptoms such as frequent headaches, dizziness, or nausea that are associated with changes in head and neck position are all reasons for you to seek immediate medical attention.

When it comes to exercises to help people manage their neck and shoulder pain, there is no shortage of potentially helpful exercises that you can implement into your daily routine. Check out the simple exercise prescription that I put together for those of you who may be suffering from neck or shoulder pain:

I have successfully implemented many of these same exercises into the treatment plans I use with my patients and while they will work well for many of you, please remember that you should not force yourself to perform any exercise that causes you acute pain.  Just because an exercise works well for someone else, does not mean it will work well for you.  Similarly, when beginning any new exercise protocol, remember to implement things gradually. Doing too much too soon can make things worse rather than better! 

It is my hope that gaining some foundational knowledge of some of the more common pathologies of the cervical spine and shoulder, as well as when to seek treatment and providing you with an example of how you can address your pain and dysfunction through exercise will help you manage your symptoms and ultimately assist you in achieving a full recovery.  Best of luck going forward.

» See instructions for pain relieving exercises

 This article was featured in the Fall 2016 Adelphi Adelphi Wellness Newsletter.

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