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Writer's pictureDr. Brandon

Is your spine to blame for your shoulder pain?


Do you deal with shoulder pain that doesn’t seem to get better no matter how how many shoulder stretches, rotator cuff exercises you do, or spending hours dealing with knots in your shoulder or upper back? Many times when people are dealing with this kind of shoulder issue, whether that is being able to lift their arm or their pain seems to spread down from their shoulders, often the undiagnosed problem is the neck. Often people who have this kind of shoulder will have an x-ray or MRI that shows that nothing is wrong with their shoulder or the scan will find little things that aren’t big enough to be causing the problem. They may even have a scan of the neck that comes back clear as well. Often this is the most frustrating kind of shoulder pain because no matter what you do it doesn’t seem to get better or if you are able to ease it, it doesn’t stay that way. This often happens because the wrong thing is being treated or the right thing is being addressed but part of the puzzle is missing.

What causes shoulder pain?

First off, the shoulder is a very complex set of joints. It is actually a complex of 4 joints, any of which can be responsible for stiffness, inability to raise your arm, weakness or instability. In addition, the shoulder relies on the upper back being flexible enough to raise your arm overhead while relying on the neck for the nerves that power the muscles to work well and at the right time. Many are told that they just need to strengthen the shoulder and everything will be alright. Others are told that they need to stretch. It is hard to know what to do let alone how to do it. Want to get to the source of your shoulder pain without the guesswork? Schedule your free total body diagnostic test with one of our shoulder specialists.

How can the neck be responsible for shoulder pain?

If the above describes you, shoulder pain that doesn’t seem to get better no matter what you do and your imaging comes back clean, often the neck can be to blame. How? Many of the nerves that come from the neck are responsible for how the shoulder feels and works. Any sort of tightness around the neck and specifically around those nerves causes your body’s alarm system to sound off. This can start with a bit of stiffness to the shoulder or neck, maybe more knots than usual around the shoulders, or even pain that might radiate down the shoulder towards the elbow. Often the source of the problem can be found by testing how the neck moves and seeing how that affects the shoulder and many times shoulder pain can be treated without ever working on the shoulder itself.

How can the upper back be responsible for shoulder pain?

Dealing with shoulder stiffness especially if it is on one side? Take this test to see if your shoulder pain or stiffness may be coming from your upper back.

So how can the upper back be responsible for shoulder pain and stiffness? Often if our posture is wrong, it curves our spine forward(think text neck or teenager posture). This then limits how our shoulder blades can move and blocks our ability to reach above our head. It can also cause impingement and damage to the tendons of the rotator cuff as they get pinched as you try to raise your arm higher.

How can I tell which is responsible for my shoulder pain?

This is the tricky part because usually it is not so cut and dried as to what is the main cause(at least initially). But, if you tried the test above and found that you were equal in each direction and could point your elbow at the ceiling then most likely your upper back is not the main issue. If you find that your shoulder is worse after working on the computer, looking at your phone, or reading or if you notice yourself in a text neck posture while picking something up overhead then your neck may be part of the problem. Try this quick posture reset to see if it makes a difference. First-find a wall. Place your heels against it with your hips and shoulder blades touching(it is OK if your low back is arching off it a bit). Now, try to touch the back of your head to the wall. Last place your arms against the wall in a “touchdown” type of position. Slowly raise and lower your arms keeping your forearms and upper arms against the wall. Now, retry reaching overhead. If better, your posture had some contribution to your shoulder pain. Can’t get your head against the wall? Your posture is more likely contributing to your pain. Can’t get to the starting position without pain? Don’t force it. It is very likely that your posture is contributing to your pain.

What to do when fixing your posture doesn’t work

Often we find that when we make some of the changes, like improving our posture, getting better pillows or mattresses, or having a better office set-up that we can reduce the number or severity of the shoulder pain but they don’t completely go away. Why? Often because some of the underlying causes of the shoulder pain remain untreated. Often our nervous system becomes so sensitive that these fixes only partly calm down our nerves, ease our stiff joints or loosen tight muscles. Sometimes we try stretches or exercises that only aggravate our spine, muscles, or pinch nerves that then flare it. Sometimes there are other reasons why our spine is causing our pain. Often there are other natural solutions to fix shoulder pain. That’s why we offer free consultations to get to the root cause of your shoulder pain.



During one of our free consultations, the Total Body Diagnostic, we offer expert advice about the worry and frustration of life-changing aches and pains – for FREE, in under 30 minutes.

If this article describes your story and you are looking for some help with shoulder or spine pain, we offer FREE consultations, which give you the opportunity to come in and meet us and see for yourself how we can help you.

Here are just a few of the things you will learn in one of our free consultation:

  • What is the underlying cause of your pain? (hopefully nothing too serious!)

  • Roughly, how long will it take to fix the problem?

  • What to do to help – which doesn’t include painkillers, resting or surgery etc.

  • What other, natural, drug free methods are there to speed up recovery alongside treatment?

Our consultations are great for anyone that may be “unsure” if physio is right for them, and they give you the opportunity to ask questions and see for yourself if we can help you.

If you’d like one of our limited free consultation sessions, please click here to request your Total Body Diagnostic or CALL us on 850-765-2779 to make a no-obligation enquiry.


About the author

Brandon Alkire, DPT, CSCS, FMS, Cert. DN

Doctor of Physical Therapy and Strength Coach

Dr. Brandon is the owner and a Physio at Body Mechanix Physiotherapy and Fitness. Four of his favorite people call him daddy while he's been married to his other favorite person for over 18 years. He enjoys teaching martial arts and is a Mestrando in Capoeira while in the mornings, he can be found working out with the guys in F3 around town.

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