Pain felt in your shoulder area can sometimes be coming from your neck. Conversely, neck pain can actually be hiding a shoulder problem.

Why? Because the neck and shoulder muscles share the same densely packed nerve pathways. And when an injury occurs, your nerves don’t always tell your brain the correct location where your problem is located. When you feel pain in one part of your body that is actually caused by pain or injury in another part, it is known as “referred pain.”

Neck Pain Referred to the Shoulder

There are many nerves and muscles that arise from your neck that pass through your shoulder on the way down the arm. Referred neck pain is usually felt at the top of your shoulder over your trapezius muscle. When shoulder pain originates from an injury in the shoulder itself, it normally is felt over your upper arm.

However, further complicating diagnosis is that many who have neck-originating shoulder pain also develop weakness in their shoulder rotator cuff muscles along with shoulder bursitis. Thus, diagnosis often requires your musculoskeletal specialist to distinguish between these different two sources of pain.

Neck-referred shoulder pain can often be from your cervical spine neck joints and ligaments, or from a trapped nerve. The common causes of shoulder pain from the neck include:

  • Spinal Osteoarthritis: a condition where disks narrow and bone spurs form.
  • Spinal Stenosis: a narrowing of the space around the spinal cord, usually due to arthritis.
  • Herniated Disk: when one of the cushioning disks between your spine’s vertebrae tear or leak
  • Ligament or Muscle Injuries: frequently the result of a sports injury, fall or accident

Shoulder Pain Referred to the Neck

One of the sources of shoulder pain that can be referred to the neck can originate in the acromioclavicular, or AC joint. So let’s simplify that a bit.

The AC joint joins your collarbone, also known as your clavicle, with the acromion section of your shoulder blade (scapula). Just like it is for most parts in your body where bones meet, there is cartilage between the two bones – which is the tissue that allows the bones to move on each other. Think of it like Teflon smoothly allowing two ball bearings to rub against each other.

While the AC joint is vulnerable to many different kinds of injuries, the most common conditions are arthritis, fractures, and separations. And AC joint pain, as well as a number of other shoulder conditions, can radiate pain to the neck.

Woman with neck pain that actually originates in her shoulder joint.
Some neck pain may actually be “referred” from a damaged shoulder joint.

Figuring Out the True Source of Your Shoulder or Neck Pain

Your healthcare provider will start with a physical examination to diagnose referred neck or shoulder pain. They’ll also be looking to rule out other possible conditions. They may couple their initial examination with imaging (MRI, CT, Ultrasound, or X-rays) and blood tests.

Recommended treatments will vary depending on what they determine the underlying condition to be.

Make an Appointment

Share This Page:

In the United States, more than 23% of all adults have arthritis. It is the swelling and tenderness of one or more of your joints. It is characterized by joint inflammation, pain, and stiffness, and it typically worsens as you get older.

There are more than 100 different kinds of arthritis and related conditions. The most common types are osteoarthritis and rheumatoid arthritis.

What’s the difference between the two? Osteoarthritis, the most common form of arthritis, involves wearing away the protective cartilage covering bones where they form a joint. On the other hand, rheumatoid arthritis is an immune system disease that attacks the joints – inflaming the protective synovial membrane, causing pain, swelling, and eventually, joint erosion.

We’ll look a little deeper at each of these conditions.

Man rubs his arthritic hands.


Osteoarthritis develops as the protective cartilage that cushions the ends of your bones gradually breaks down over time. This allows the bones in joints to rub against each other. When the cartilage deteriorates, joints no longer have the padding they need to move and extend properly.

This condition causes severe joint pain and stiffness. Although osteoarthritis can affect any joint, it frequently affects joints in the hands, neck, back, knees, and hips.

Inflammatory Osteoarthritis

For years the prevailing view was that osteoarthritis was mainly the result of a lifetime of “wear-and-tear” on joints. As a result, it was easy to classify arthritis as either non-inflammatory, such as osteoarthritis, or inflammatory, such as rheumatoid arthritis.

However, there are forms of osteoarthritis that are now recognized as being inflammatory. This variant typically comes on suddenly in middle-aged women, affecting the joints of the fingers. Thus, it’s crucial to get a proper diagnosis because treatment for this inflammatory form of osteoarthritis is different from the treatment for rheumatoid arthritis or typical osteoarthritis.

Osteoarthritis Treatment

Osteoarthritis pain symptoms can be relieved with medications such as acetaminophen (Tylenol and others) and nonsteroidal anti-inflammatory drugs (Advil, Motrin IB, and others). A physical therapist can also show you exercises to strengthen the muscles around your joint, increase your flexibility, and reduce pain.

If these conservative approaches are insufficient, your doctor may recommend cortisone injections to relieve pain in your joint. If the joint in question is the knee, injections of hyaluronic acid, also known as viscosupplementation, may also offer pain relief by providing some cushioning in your knee.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic, inflammatory autoimmune disorder that can affect more than just your joints. It occurs when your immune system mistakenly attacks your own body’s tissues.

Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity.

Rheumatoid arthritis symptoms may include swollen joints and joint stiffness, particularly after waking, fatigue, fever, and appetite loss. Nearly half of those with rheumatoid arthritis also experience symptoms that don’t involve joints but extend to other body structures such as skin, eyes, nerve tissue, and organs.

Rheumatoid Arthritis Treatment

The goals for treating rheumatoid arthritis are to control a patient’s symptoms, prevent joint damage, and maintain a patient’s quality of life and ability to function. Since joint damage occurs within the first few years after the onset of rheumatoid arthritis, it is crucial to diagnose and treat it early to minimize long-term issues. Treatments include medications, rest, exercise, and physical therapy. In some cases, surgery is also appropriate to correct damage to a joint.

The type of medications your doctor recommends will depend on how severe your arthritis is and how well you respond to the medications. These medications include nonsteroidal anti-inflammatory drugs (NSAIDs), Corticosteroids, COX-2 inhibitor, disease-modifying anti-rheumatic drugs (DMARDs), and biologic agents (which tend to work rapidly).

Advances in Treatment

The effects of rheumatoid arthritis and osteoarthritis on a person’s life can range from mild to severe. While they have some similar symptoms, they have very different causes and require different treatments. Osteoarthritis usually affects fewer joints than rheumatoid arthritis and doesn’t involve autoimmune issues, making it easier to treat. The progression of rheumatoid arthritis is more challenging to predict than is osteoarthritis.

Breakthroughs in medical science are also helping researchers optimize existing treatments and develop new treatment approaches for managing rheumatoid arthritis. To learn more about the latest treatment options and how they might help you, talk to your doctor.

Make an Appointment

Share This Page: