A shoulder injury can absolutely cause neck pain. The two areas are closely connected by a dense network of muscles, nerves, and shared biomechanics, meaning an issue in one region frequently creates symptoms in the other. When the shoulder joint is injured, the nearby cervical spine (neck) is often forced to compensate. This relationship explains why pain signals can travel from the shoulder and register as discomfort in the neck, making it challenging to pinpoint the true source.
Shared Anatomical Connections
The physical connection between the neck and shoulder is rooted in shared nervous and muscular pathways. Nerves providing motor and sensory function to the entire arm and shoulder originate directly from the neck’s spinal cord. The brachial plexus, a major bundle of nerves, forms from spinal nerve roots C5 through T1, exiting the neck and passing through the shoulder region to the arm.
Irritation or inflammation in the shoulder can directly affect these nerves as they travel through the area, causing pain that the brain perceives as originating in the neck. This neural overlap is a primary reason why pain can radiate or be “referred” between the two regions.
Large, overlapping muscle groups also physically link the two structures, acting as a single functional unit. For instance, the trapezius muscle spans from the base of the skull and neck down to the shoulder blade and collarbone. The levator scapulae muscle originates in the neck and attaches to the upper corner of the shoulder blade. When a shoulder injury restricts movement, these shared muscles become strained, translating shoulder dysfunction into neck stiffness and pain.
Mechanical Compensation and Pain Referral
A shoulder injury often triggers neck pain through two distinct processes: mechanical compensation and true referred pain. Mechanical compensation occurs when the injured, painful, or restricted shoulder alters the way a person moves their arm and upper body.
To protect the injured shoulder or achieve necessary range of motion, the body unconsciously recruits muscles in the neck and upper back to take over the work of weakened shoulder muscles. This protective mechanism, often called muscle guarding, forces the neck muscles to manage loads and stabilize movements they were not designed for.
Over time, this chronic overload causes strain in muscles like the upper trapezius, leading to persistent tension and stiffness felt in the neck and the base of the skull.
Pain referral, on the other hand, is a neurological phenomenon where the brain misinterprets the origin of a pain signal. Since the nerves innervating the shoulder and the neck converge at the same spinal cord segments, irritation from a shoulder injury can be mistakenly perceived as pain in the neck area. This pain is often described as a dull ache or discomfort near the upper, inner corner of the shoulder blade, a common site of referred pain from the shoulder.
Specific Shoulder Conditions Leading to Neck Pain
Several common shoulder injuries result in secondary neck pain due to these anatomical and mechanical links. A rotator cuff tear, which involves damage to the muscles and tendons stabilizing the shoulder, frequently causes neck discomfort. The tear leads to instability and weakness, forcing the neck and upper back muscles to become overactive stabilizers, straining the trapezius muscle as it tries to hold the shoulder in place.
Shoulder impingement syndrome, where rotator cuff tendons are compressed during arm movement, is a frequent cause of neck pain. The pain from the inflamed tendons can be referred directly to the neck area, sometimes presenting as chronic pain near the top of the shoulder blade. People with impingement often instinctively “hike” their shoulder to avoid the painful pinching motion, which chronically tenses the neck muscles.
Injuries to the acromioclavicular (AC) joint, located where the collarbone meets the shoulder blade, can radiate pain into the neck. This joint receives sensation from nerves that branch directly from the neck. Inflammation or separation of the AC joint can cause pain that travels along this nerve pathway, often spreading along the trapezius muscle toward the base of the neck.