Neck & Shoulder Pain
Commonly Found With Chronic Muscle Strain
Neck & Shoulder Pain Causes Are Many ….
Problems with neck joint and nerve injury, degenerative disc disease or cervical spondylosis, disc damage along with muscle strain can refer pain to these areas in certain patterns.
The most common complaints of chronic neck pain and shoulder pain I have seen is caused by strain in 2 particular muscles which connect the neck and shoulder. The first muscle is the levator scapula which uses the neck as a base to raise the shoulder from the back. This muscle is discussed in detail under causes of a stiff neck.
The other muscle which commonly causes neck and shoulder pain is the Trapezius. This is a complex muscle often called “The Coat Hanger” which can also cause pain into the head and at the base of the skull.
The areas marked by an “X” are the main points of strain and the red areas show pain patterns that result.
Common causes are from stress of constant chronic elevation of the shoulders as in holding a phone without proper elbow support or sitting in a chair without proper armrests. Other causes are injury to the joints from a side to side force and long term or chronic compression of the muscle as with tight bra straps or a heavy coat that does not fit right. Other less common causes are skeletal variations such as a short leg, pelvis or arms.
Treatment of the muscle itself should be directed at the “x” and often responds well to heat and massage. This is a particularly difficult muscle to reach so I recommend a tennis ball while lying on your back or use a back massager, cane massager or neck and back massager to self treat the middle and lower areas of strain using massage. A hot shower works great or a neck wrap which provides moist heat to the neck and shoulder areas together. A properly supported armrest is about 9 inches above the seatrest.
As a part of neck & shoulder pain treatment, in addition to correcting any postural problems and reviewing neck exercises, I also like to demonstrate a nice stretch to mobilize the middle and lower part of the trapezius, especially for inactive people or if you sit at a computer all day.
Lie on your back and place elbows, forearms and palms of hands together in front of your chest. Keep the elbows held as close as possible while you raise the arms over your face.
Then drop the arms to the floor. Keep the back of the elbows and wrists in contact with the floor and swing the arms down against the sides of the body. Pause and relax while practicing several cycles of breathing exercises and repeat the stretch.
Factors related to neck and shoulder pain
Neck and shoulder pain is very common in the general population. Neck & shoulder pain disorders are prevalent among both women and men. Work related factors, both of physical and psychosocial origin, as well as lifestyle factors, have been identified as being associated with a high prevalence and incidence of neck and shoulder pain. Repetitive hand and finger movements and monotonous work tasks, awkward postures, duration of sitting and twisting and bending of the trunk, adverse psychosocial conditions at work, and smoking are examples of such factors.
There is an association with initiating therapy for neck and shoulder pain with physical factors along with psychological and social factors in a working environment. Increasing neck & shoulder pain corresponds to increased number of years working at a certain job is noted with sewing machine workers, assembly workers, and secretaries indicating a dose related response of exposure in these type of working conditions. The prevalence of neck problems increases with amount of hours in a day with computer use and amount of time with shoulders raised.
Cumulative trauma of the neck & shoulder is not very well understood. Due to physical exposure, an increase in muscle activity may start a cycle of neck and shoulder muscle pain in working environments consisting of repetitive tasks and awkward working positions. It is possible that muscles first used in a contraction are the last to achieve relaxation because of this increase in activity. Overuse of the muscles can cause pain and chronic fibrosis (scar tissue) leading to inflammation and altered patterns of motion. The lack of ability to relax the neck and shoulder muscles, even at rest can predict trapezius myalgia and may additionally relate to a tension neck syndrome.
Short term exposure to work above shoulder level, frequent bending and twisting at work and lifting heavy loads produced higher relative risks of neck & shoulder pain.
Sitting work for more than 95% of the working day has been identified as a risk factor for neck pain. The risk of seeking care for neck or shoulder pain is nearly double among those who perceived an increase in workload. Long term exposure to hindrance at work, an increase of exposure to reduced opportunities to acquire or use new knowledge, or lack of opportunity to participate in planning of the work are associated with seeking care because of neck and shoulder pain. It has been found that psychological stress may result in muscle contractions.
The experience of being affected by changes without being able to influence anything, or seeing how skills that used to be of importance lose their relevance, seems to be associated with seeking care because of neck & shoulder pain. It seems that for the few people for whom work has become more demanding, the risk of developing neck & shoulder pain has also increased.
Neck or shoulder pain is more common among women and is associated with a combination of physical and psychosocial factors, both at work and in the family setting. Among women, an increased amount of computer work, work in a seated position, work above shoulder level, and reduced opportunities to acquire new knowledge, and among men, an increased amount of sitting at work were associated with neck and shoulder pain. Please see tips for correct posture when sitting at the computer.
Shoulder and neck symptoms have been linked to jobs with highly repetitive work, static work, and work above shoulder level. However, this mechanical exposure explains only part of these complaints. The role of psychosocial factors in the workplace has therefore received increasing attention. On the job pressure, monotonous work, and a high perceived workload have also been associated with neck and shoulder pain just as much as working situations characterized by high psychological demands, low decision latitude, and low social support.
Mechanical exposure for men and job strain (the combination of high job demands and low job decision latitude) for women are factors most strongly associated with a higher risk for developing shoulder and neck pain.