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This article is a transcribed edited summary of a video Bob and Brad recorded in August of 2020. For the original video go to https://www.youtube.com/watch?v=UoVPGhEOHf0
Bob: The topic today “Is Your Shoulder Pain Coming from Your Neck or Shoulder, How to Tell.” Very difficult to assess sometimes but we’re going to give you a few clues here.
Brad: And it’s common that, you can have shoulder pain coming from your neck, but it was just misdiagnosed, or the layperson wouldn’t know until you see this video.
Bob: Right, so let’s start right into it Brad. If you have neck problems, they often can cause pain into the shoulder area. As a rule, shoulder movements tend to aggravate shoulder problems. Neck movements tend to aggravate neck problems. So, we’ll be doing some tests at the end and show you how that works.
Brad: With the except for some neck movements, which can produce symptoms in the arm.
Bob: That’s a good point. We’ll get into this.
Brad: Yeah, it gets a little complicated but stick with us and it’ll be more clear.
Bob: First, let’s go typical location of the pain, okay. If you have shoulder pain, often it’s in the front or the side of the shoulder. It may radiate down the arm, but generally it doesn’t go past the elbow. Both Brad and I have seen patients where it did go past the elbow, but unlikely and it went into the forearm.
Brad: Usually their shoulder pain was high. We’re talking in general terms, not on their exceptions.
Bob: If you have pain in the neck now that’s generally felt at the base of the neck. It can be felt in the shoulder blade. That’s common. Shoulder blade generally is not a shoulder problem, it’s a neck problem. You might feel it going down the arm. If it radiates down into the hand and wrist and fingers, then you’re almost certainly dealing with a neck problem. And if you have numbness and tingling with it, that generally is a neck problem, although you said you occasionally have seen it, with shoulders.
Brad: Yeah, usually not. And if you’re wondering the pain going into the fingers and the numbness and tingling, it’s a pinched nerve. Usually, pinch nerves in that location happen in between your neck and shoulder. Not so much in the shoulder.
Bob: So, as a rule, if you have numbness and tingling, there’s a good chance of a neck problem. So, we’re going to show you some tests for a shoulder problem. What we’re going to do is we’re going to have you first slowly flex your arm forward with good posture. Slowly flex it five times, just straight up and down. Now, if this starts to aggravate your pain, good possibility it’s the shoulder.
Brad: Particularly if it’s in the shoulder itself, maybe radiating down a little bit.
Bob: Now you’re going to slowly go out to the side five times. Thumb up, thumb pointed up. And the same thing with this if this aggravates it, maybe flexion didn't aggravate it but abduction does, it's likely from the shoulder.
Brad: And if you get your arm halfway up and it hurts both directions more than likely it’s a shoulder rotator cuff issue or impingement.
Bob: And if you can’t raise it hardly at all.
Brad: Yeah, you’re compensating moving your body a lot. You’re probably sore and it's more likely a shoulder issue.
Bob: Last one you’re going to do five times; you’re going to reach back behind you and attempt to touch your shoulder blade.
Brad: Yeah, usually you compare your good arm. I can go way up there with my good arm, but with my bad arm it reaches to my lower back. That's more than likely a shoulder issue.
Bob: Yeah, he definitely has some shoulder involvement. One thing we haven’t point out Brad, is you could have neck and shoulder problems simultaneously.
Brad: You bet.
Bob: So, now let’s test the neck. So, let’s you did those, and you really didn’t have any pain. With the neck, you’re going to flex it down and extend way back. Now you’re going to do this ten times Brad. You’re going to see if this irritates it and starts sending pain anywhere, in the neck or down the arm. Even if it just starts causing pain in the neck, it might still be a shoulder issue because it might eventually over time start going down the shoulder.
Brad: I've found this a lot, I’ll have the patient do this one forward and the very first time they get their head halfway back, it hurts all the way down to the shoulder. Then don’t do it ten times, just stop. You’ve got a neck problem if you can’t do that.
Bob: And that is probably the most common one that’s going to be tight is going back like that with your neck. Well, I shouldn’t say most common. It hurts for a lot of people going forward too.
Brad: Yeah, and we’re going to talk about rotation a little bit.
Bob: Rotation, same thing. You can go back and forth, and you go ten times and see if that irritates it. Generally, it’s going to be one side that irritates it. It could be either one.
Brad: You might be able to go full range one way and the other way you only go half, and it starts to hurt. That’s common. It’s a neck problem, more than likely.
Bob: Yeah, and the last one is that you can side bend. To left and to the right, same thing.
Bob: You’re going to find out, you might be tight one direction and that it brings on the pain. We’re answering some of the questions today, Brad. Someone said every time they bend their neck one way, their arm goes numb. There’s a neck problem. So, there we go. Again, if you have any questions, go see your professional and have it diagnosed. Thanks!
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