Cervical Related Shoulder Pain: Why Neck Issues Can Feel Like a Shoulder Problem

By Chris Wright, Physiotherapist

Shoulder pain is one of the most common complaints people present with in everyday life, whether from sport, work, or daily activities. But not all shoulder pain actually originates from the shoulder joint itself. In many cases, the true source of the discomfort lies higher up in the cervical spine (your neck). (1)

How Cervical Pain Can Mimic Shoulder Pain

The nerves that supply sensation and strength to your shoulder and arm travel down from the neck. When the cervical spine is irritated, for example by a stiff joint, a disc injury, or muscle tightness, the pain can radiate into the shoulder, upper back, or even down into the arm. This often feels like a dull ache, burning, or even sharp pain around the shoulder region, making it easy to mistake for a shoulder injury. (1)

Because of this overlap in nerve pathways, people can spend weeks or months thinking they have a rotator cuff or shoulder joint problem when in reality the root cause lies in the neck.

Common Signs That Shoulder Pain May Be Cervical in Origin

• Pain that radiates beyond the shoulder into the arm or hand

• Tingling, pins and needles, or numbness

• Weakness in the arm or grip

• Pain that worsens with neck movements (looking up, down, or turning)

• Shoulder scans or imaging showing minimal findings, despite ongoing symptoms

Why an Accurate Diagnosis Matters

Treating the wrong problem leads to frustration and wasted time. For example, strengthening exercises for the rotator cuff will not resolve pain if the underlying driver is irritation coming from the cervical spine. This is why a thorough assessment is critical.

A physiotherapist or osteopath can carefully examine your neck and shoulder to determine the true source of your pain.(2) Using specific movement tests, nerve checks, and hands-on assessment, they can distinguish whether your pain is:

• Primarily shoulder-related

• Referred from the cervical spine

• Or a combination of both

How Physiotherapy and Osteopathy Can Help

Once the cause is identified, treatment is tailored to your needs. (3) This may include:

• Manual therapy to restore mobility in the cervical spine

• Postural education and ergonomic advice to reduce strain

• Targeted exercises to strengthen both the neck and shoulder region

• Nerve mobility techniques if irritation is present

• Guidance on safe return to activity or sport

Takeaway

Not all shoulder pain comes from the shoulder. Sometimes, your neck is the true culprit. If you are experiencing persistent shoulder discomfort, especially if it spreads into your arm or does not improve with rest, it is important to seek professional advice.

A physiotherapist or osteopath can help you get a clear diagnosis, guide you with the right treatment, and put you back on track to moving freely and comfortably. Click here to book in.

References

1.         Katsuura Y, Bruce J, Taylor S, Gullota L, Kim HJ. Overlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review. Global Spine Journal. 2020;10(2):195-208. doi:10.1177/2192568218822536

2.         Gumina S, Carbone S, Albino P, Gurzi M, Postacchini F. Arm Squeeze Test: a new clinical test to distinguish neck from shoulder pain. Eur Spine J. Jul 2013;22(7):1558-63. doi:10.1007/s00586-013-2788-3

3.         Boyles R, Toy P, Mellon J, Hayes M, Hammer B. Effectiveness of manual physical therapy in the treatment of cervical radiculopathy: a systematic review. Journal of Manual & Manipulative Therapy. 2011;19(3):135-142.