Neck and Shoulder Pain May Be Interconnected
Injury to the ligaments of the neck can cause many types of aggravating and even disabling symptoms due to the multifaceted issues that stem from the instability that occurs in the neck when these ligaments are injured. Even though neck instability alone can generate a host of symptoms, there are occasions when the neck and the shoulder are both involved in eliciting pain and symptoms. Shoulder pain can also be complicated, because the joint is so flexible, making it more prone to injuries. But the interconnected duo can add to the complexity. In cases where both areas are involved, neck pain can refer to the shoulder due to the various joint attachments. If only the shoulder is treated, inadequate healing may occur due to the connection with the neck, which may need to be treated as well. An awareness of the interplay needs to be considered in treatment plans of those with neck and shoulder pain.
What Happens with Neck Instability?
When the neck or cervical spine is stable, it moves and functions normally. The neck remains in proper physiologic alignment, which protects the blood vessels, nerves and spinal cord. The neck has seven cervical vertebrae, with facet joints adjoining them, which help the neck to be flexible, bend, and twist. Nerves exit the spinal cord through these joint on their way to other parts of the body. If the ligaments become injured, these facet joints can get too much movement, which leads to neck instability. At this point, the cervical spine or neck has difficulty handling the demands placed upon it and the support becomes inadequate. A cycle of imbalance is created, generating changes in the alignment of the vertebrae of the neck and the adjacent joint structures. It’s not unlike a wobbly bicycle wheel that will eventually make the handle bar turn, and create a situation where riding is incredibly difficult. Increased motion in the facets will increase motion between the adjacent vertebrae and eventually the adjacent joint structures, including the shoulder joint. All of this extra motion causes excessive stress on the ligaments that are trying to support these structures. With this abnormal movement of the joints, the nerve endings within those structures will elicit pain and a variety of symptoms will be experienced.
More about the Shoulder
The shoulder is one of the most flexible joints in the body. It’s a ball and socket joint, with a huge range of motion. The mobility and flexibility are great things, and come in very handy for all of the sports and activities they help us to perform. But when we use the shoulder over and over, the wear and tear from the repetitive movements or the damage from a current or previous injury can cause the supporting ring of ligaments in the shoulder to become too loose, allowing for excessive movement in the shoulder. Just like the neck, the extra movement will eventually lead to pain and make the shoulder susceptibility to further injury. The muscles that move the shoulder are called the rotator cuff muscles. When the ligaments of the shoulder are injured, these muscles are then called upon to try and keep the shoulder stable. The muscles will spasm from overuse, and they too will eventually fatigue, which may possibly lead to tears of the rotator cuff or injury to other joint structures.
The Interconnectedness of the Shoulder and the Neck
The neck and shoulder are interconnected via joint structures and attachments, and this is why injury to one of them can affect the other. The anatomy of the neck and shoulder involves muscles and other soft tissue that overlap. When pain in these areas is experienced, it is essential to have a skilled clinician who can examine the structures and discern where the pain is coming from. It is very important to physically examine the patient, and carry out a functional exam. At times, if an MRI is ordered, only one of these areas (rather than both), will be imaged, and the root problem might be missed. The underlying problem may very well be injured tendons and ligaments. The ligaments become unstable at some point, which causes the tendons to wear out. For example, a patient may be seen due to an MRI that shows they have shoulder spurs. But the spurs may not be what are producing the pain. When the area is examined by the physician, the underlying problems generating the pain may be the supra and infraspinatus tendons, which have become weakened by taking up the slack which originated from injured ligaments.
The ligament injuries may be old injuries in the shoulder or neck structures, which occurred earlier in life, such as from a sports injury, fall, or motor vehicle accident. The ligament injury could also be an overuse injury, such as that produced by prolonged overhead activities/swings, poor posture, or forward head positioning from repetitive mobile device usage. These injuries progress to unrelenting pain conditions, which may be helped temporarily by various therapies, but which often remain unresolved, because many conventional therapies are unable to heal ligament injuries. Tendons and ligaments have difficulty healing as a result of having a poor blood supply. Fortunately, Regenerative Orthopedic therapies, such as Stem Cell Therapy, PRP, and Prolotherapy repair structures like ligaments, tendons, and the rotator cuff, by increasing the blood supply to these structures and by giving the body, which has great reparative capabilities, the boost to heal itself. These regenerative options are a huge piece of the puzzle in helping people get better.
Shoulder, neck pain and instability can be successfully addressed with Regenerative Orthopedic techniques. This natural injection therapy strengthens loose and unstable joints and their ligaments and other soft tissue, creating more stable, strong, and pain-free movement in both the neck and the shoulder.
