Is it shoulder pain? Or a pain in the neck?

Sometimes the pain that you experience is vague and it can be hard to describe where it’s coming from.


Differentiating the true cause of shoulder and cervical (neck) pain represents a difficult challenge, with approximately one fourth of patients experiencing both problems.  To further complicate things, pain reported in the neck may represent referred pain from the shoulder girdle, and vice versa.

“A remedial massage therapist’s perspective may be really useful here, as they’ll often take a broad view and may consider out-of-the-box explanations such as referred musculoskeletal pain and trigger points.”

It’s really important to get a good picture of the type of pain you are feeling.  Important factors such as the cause of your pain, how long you’ve had it, how its progressed, what relieves it, and what makes it worse, are all important clues that can help to narrow things down.


For example, dull and aching pain is more consistent with shoulder pathology, whereas burning or electric type pain is more indicative of cervical spine or neurologic origin.  Painful arm abduction (raising your arm up, away from your body) is consistent with shoulder pathology, whereas arm abduction may relieve symptoms in patients with cervical radiculopathy.


Shoulder pain is widespread.  It’s one of the most common musculoskeletal complaints, affecting 18-26% of adults at any point in time.  The basis of treatment for shoulder disorders is centered around controlling pain and restoring function.  Soft-tissue massage techniques are used extensively during physical therapy treatments for shoulder pain and their effectiveness is supported by a growing body of literature.


The bottom line is this:  Your massage therapist needs to be aware of the potential overlapping pattern of pain and dysfunction resulting from neck and shoulder disorders and always consider both in their assessment and treatment.



Artus, M., Holt, T. A., & Rees, J. (2014). The painful shoulder: an update on assessment, treatment, and referral. British Journal of General Practice, 64(626), e593–e595.

Bokshan, S. L., DePasse, J. M., Eltorai, A. E. M., Paxton, E. S., Green, A., & Daniels, A. H. (2016). An evidence-based approach to differentiating the cause of shoulder and cervical spine pain. The American Journal of Medicine, 129(9). 913-918.

Linaker, C. H., & Walker-Bone, K. (2015). Shoulder disorders and occupation. Best practice & research. Clinical rheumatology, 29(3), 405–423.

Steuri, R., Sattelmayer, M., Elsig, S., Kolly, C., Tal, A., Taeymans, J., & Hilfiker, R. (2017). Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: A systematic review and meta-analysis of RCTs. British Journal of Sports Medicine 51(18), 1340-1347.

Yeun Y. R. (2017). Effectiveness of massage therapy for shoulder pain: a systematic review and meta-analysis. Journal of physical therapy science, 29(5), 936–940.

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