Neck/Shoulder Pain

Neck and/or shoulder pain and stiffness are usually caused by strain or spasm of the neck or shoulder muscles, or inflammation of the neck or shoulder joints. It may occasionally be due to arthritis or damage to the discs between the vertebrae (small bones) of the neck.

The pain may be accompanied by headaches, limitations on the movement of the neck, or pain, tingling or numbness down the arms.

Neck and shoulder pain is typically caused by improper body mechanics or poor posture particularly after sitting at a computer, talking on the telephone, watching TV or reading for extended periods, or falling asleep sitting up. Stress is another common cause. Neck or shoulder pain may also occur when you have the flu, after you've engaged in strenuous activity, or as the result of an injury that causes sudden movement to the head and neck (whiplash), or by a direct blow to the area.

Most strains will heal naturally, but it can be a slow process. The following Kaiser Permanente self-care information is designed to assist you in recovering from your neck or shoulder pain and in preventing further problems.

Please try the suggested home treatments for two weeks. If, after one week, there is no improvement, your condition worsens or if further complications develop and you experience any of the symptoms mentioned above, be sure to call your Kaiser Permanente advice nurse or doctor.

Dealing with Neck or Shoulder Pain in the Early Stage:

• Don't do anything that increases the pain. Avoid strenuous activity, such as lifting, that involves the use of your upper body.
• Move gently and frequently.
• Apply ice to the painful area to reduce the pain and muscle spasm for at least the first three days. Place ice or a cold pack on the affected area for 15-20 minutes, three or four times a day OR up to once an hour for at least the first three days.
• Moist heat, such as warm showers may also be helpful. Avoid slouching in a bath tub.

For more information regarding the proper use of ice and moist heat, click this button.

If the pain is tolerable, continue your daily routine, keeping the following information in mind:

• Keep your head and neck in the neutral position over your body. Avoid slouching, forward head posture, or staying in one position for too long.
  
• Stand, sit and lie down with your ear, shoulder and hip in a line, if viewed from the side. Keep your shoulders back and down, not rounded and forward.
  
• Walking is often good for relieving neck pain.
  
• Once the pain subsides, exercises which increase your strength and flexibility, and improve your posture, can be helpful. For specific neck and back exercises, refer to page 68 of your Kaiser Permanente Healthwise Handbook.
  
• All types of strains and injuries, including neck pain, heal better if you drink lots of liquids. Water works best, so drink lots of it.

It is important that you learn to stand, sit and sleep in correct positions so that you do not aggravate your neck or shoulder injury and to allow it to heal properly. Using correct posture and body mechanics are the keys to neck and shoulder comfort, and may prevent future problems. Consider the following:

• Support your lower back when sitting. Use a chair with good back support. Avoid soft surfaces such as the sofa.
  
• When sitting down, or getting up from a seat, try to bend at the hip in order to keep your ear, shoulder, and hip in a straight line (when viewed from the side.)
  
• Try to avoid staying in one position for too long. If you have to stand in one place for more than 10 minutes, you might find that putting one foot and then the other on a raised surface (of about 4-6 inches) adds to your comfort.
  
• When reading or writing, adjust your materials so you don't have to bend your neck forward or to the side.
  
• Do not sleep on your stomach or with your neck bent or twisted. Avoid using pillows that force your head forward when you are sleeping on your back. Consider getting or making a neck support pillow. Sleep on a firm surface. When sleeping on your side, make sure that your nose is in line with the center of your body.
  
• You might also try folding a pillow case lengthwise into a four inch wide pad and wrapping it around your neck (you can pin it to keep it in place) while sleeping.

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