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Neck and shoulder pain

Summary

The neck and shoulders are prone to injury. Trauma, poor posture and arthritis are common causes of neck pain. Injuries include whiplash, acute tendonitis or degenerative tendinosis, fractures and dislocation of the shoulder. Treatments like physiotherapy, osteopathy or remedial massage can generally help neck and shoulder pain.

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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.

Whiplash injury


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 and place a shearing force on 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 person and the extent of the injury, but can take weeks to months.

Treatment for whiplash may include:
  • pain-relieving medication
  • anti-inflammatory or muscle relaxant medications
  • 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.
Maintaining your normal daily activities is ideal, although modifications may be necessary to help with the recovery of your neck. Be adaptable and remain positive. If pain persists, a further examination or investigation may be required.

Wry neck


Wry neck is the term used to describe a common condition where your neck suddenly becomes stiff and painful. Turning your head to the side (generally one side more than the other) and looking up can produce an acute ‘catching’ pain.

One or both sides of the neck may also go into spasm, and pain may be felt from the top of the neck down to the shoulder blade and even out to the top of the shoulder.

Causes of wry neck


There are many causes, commonly:
  • poor sleeping posture
  • a sudden flicking or jerking of the head
  • viral infection
  • carrying heavy unbalanced loads – such as a suitcase
  • exposure to cold breezes.

Treatment for wry neck


In most cases, if treated early, wry necks can respond well to treatment in a few days. Heat, massage and mobilisations can be used to loosen the neck joints, and reduce the pain and muscle spasm.

In rare cases, particularly for those people over 40, or very rarely in infants, wry neck can have underlying neurological involvement. Your doctor or therapist can help with this diagnosis and referral.

Self-care of wry neck


While you are recovering from wry neck, don’t:
  • sit or lie with your neck in an awkward position
  • go out in the cold without being well wrapped up.
Useful tips include:
  • Use a hot water bottle wrapped in a towel or have hot showers for pain relief.
  • Keep warm.
  • Keep moving your neck as pain allows.
  • Talk to your doctor or chemist about pain medication if your pain is severe.

Posture problems and neck pain


Poor posture can cause neck pain by putting extra strain on ligaments and muscles. Standing with your shoulders slouched and chin poking 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.
  • Make sure 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.

Shoulder injuries


Diagnosing the cause of shoulder pain involves assessing the degree of movement and strength in the joint, and possibly taking an x-ray or ultrasound.

Some of the conditions that commonly cause shoulder pain include:
  • strains due to overexertion
  • acute tendonitis or degenerative tendinosis due to overuse
  • shoulder joint instability
  • dislocation
  • collar bone 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 may help with short-term relief
  • information on how to correct postural problems.

Where to get help

  • Your doctor
  • Pharmacist
  • 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/tendinosis and fractures.
  • Treatments like physiotherapy, osteopathy or remedial massage can generally help neck and shoulder pain.

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Last reviewed: November 2013

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.


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The neck and shoulders are prone to injury. Trauma, poor posture and arthritis are common causes of neck pain. Injuries include whiplash, acute tendonitis or degenerative tendinosis, fractures and dislocation of the shoulder. Treatments like physiotherapy, osteopathy or remedial massage can generally help neck and shoulder pain.



Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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