Neck Pain, Upper Back Pain and Shoulder Pain A Chiropractor's Perspective
Posted: Monday, June 15, 2009
by Steven Jones
Steven R. Jones, D.C.
As a practicing chiropractor, I see a large number of patients with neck pain or upper back pain that begins to affect one or both shoulders. Frequently, the opposite occurs as well where a shoulder injury aggravates the neck. The biomechanics of the shoulder joint and the joints of the neck and upper back are dependant on each other for proper function. Many conditions of the neck and upper back affect the shoulder and visa versa. There is a good reason as to why this happens and I will use this article to explain it.
In a kinematic chain, the function / health of adjacent joints are dependant on each other. A simple example of a breakdown among joints in a kinematic chain and the resulting consequences would be as follows; a person sprains their ankle, limps on that ankle for several days and then develops knee pain secondary to the limp caused by the injured ankle. If the limping or gait impairment continues for any period of time, the irritation can involve the hip and eventually the low back. The ankle, knee, hip, sacroiliac joints and the joints of low back all form a kinematic chain.
In a similar yet more complicated kinematic chain, the vertebra of the cervical and thoracic spine are intertwined with the shoulder joints. The shoulder is made up of a series joints that allows for a tremendous amount of movement in a number of planes.
Compared to the knee, for example, that only allows for about 120 degrees of flexion and very little rotation and translation, the shoulder is incredibly mobile. While, like the shoulder joint has ligaments and a joint capsule that tie the humorous to the scapula and the clavicle, the primary source of stability of the shoulder joint is the muscles, many of which attach into the cervical and thoracic vertebra.
Regarding the spine in particular the cervical and thoracic spine the joints found in the spinal column have considerably less motion than do most other joints in the body. That being said, the cervical spine displays the greatest amount of motion found in the spine while the thoracic spine is the most limited in its flexibility. The fact that many of the big muscles of the neck and upper back insert onto the scapula and the clavicle links these two joint complexes together.
In many cases, shoulder pain or dysfunction can result in spasms of the larger muscles that act to stabilize the shoulder most of these muscles originate from the vertebra of the neck and upper back. The stress of this spasm can cause pain or dysfunction in the neck and upper back. Because of the shared muscles between the neck, upper back and shoulder girdle, the exact opposite scenario can occur with a primary spinal problem causing muscle spasms that have a negative effect on the shoulder.
Both the shoulder and the neck joints display complex, compound movements. Adjacent joint complexes like these that share major muscle groups make for an increased likelihood of pain / dysfunction affecting more than one group of joints.
In my practice, the two most common activities that I see that lead to pain / dysfunction of the neck, upper back and shoulder are computer work and single sided sports injuries like pitching, bowling, golf, etc. When confronted with neck pain and shoulder pain, I advise my patients to apply ice packs to the affected area in 20 minute sessions at least twice daily and limit the offending activity for two or three days. If the joint is not dramatically better with this at home management, get in to see a chiropractor. Chiropractors are specialists in joint biomechanics and can help you make a complete recovery from many cases of neck pain and shoulder injuries.
Author: Dr. Steven R. Jones DC (Steve), is a licensed Chiropractor in the state of California. Dr. Jones completed his pre-med education at California State University Hayward. He finished his doctorate work at Palmer College of Chiropractic-West. Dr. Jones has treated his patients for over 15 years at his own San Diego Chiropractic practice " Jones Chiropractic Clinic ". He holds a U.S. Patent on the ergonomic device, the "Ergo Nav" , the only fully adjustable mouse platform on the market.
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