The Differential of Arm Pain, Is The Source Coming From The Neck or The Shoulder?

Differentiating between arm pain originating from the shoulder versus the neck can be challenging, as both areas can produce similar symptoms. However, there are some key differences and specific signs that can help you distinguish between the two:

Arm Pain from the Shoulder

  1. Location of Pain: Shoulder pain typically presents around the shoulder joint itself. The pain may be localized to the front or top of the shoulder or in the deltoid muscle area.
  2. Limited Range of Motion: Shoulder issues often result in limited range of motion in the shoulder joint, making it difficult to lift your arm or perform certain movements like reaching behind your back or overhead.
  3. Pain with Shoulder Movements: Pain originating from the shoulder tends to worsen with specific movements of the shoulder joint, such as reaching overhead, lifting objects, or rotating the arm.  Shoulder pain should not radiate past the elbow.
  4. Shoulder Instability: If the pain is due to shoulder instability or a rotator cuff injury, you may experience a feeling of looseness or instability in the shoulder joint (where you feel the shoulder slide out of place), along with pain.
  5. Local Tenderness: You may notice tenderness and discomfort when pressing on specific areas around the shoulder joint, such as the acromioclavicular (AC) joint or the rotator cuff muscles.

Arm Pain from the Neck:

  1. Radiating Pain: Pain originating from the neck often radiates down the arm, following a specific nerve pathway. You may experience pain, tingling, numbness, or weakness that travels from the neck into the shoulder, arm, and possibly even into the fingers.  Shoulder pain radiating past the elbow always deserves a work up to see if it originates from the neck. 
  2. Neck Pain: Neck pain is often present along with arm pain when the issue originates from the cervical spine. You may notice discomfort, stiffness, or pain in the neck region.  You may also complain of pain along the shoulder blade which is more commonly referred from the neck than the shoulder. 
  3. Neck Movement Aggravates Pain: Certain neck movements, such as bending the neck forward, backward, or rotating it, can worsen the pain in the arm. This is because these movements can further compress the affected nerve root.
  4. Specific Distribution: The pain might follow a specific dermatomal pattern, corresponding to the nerve roots originating from the neck.
  5. Muscle Weakness: Cervical radiculopathy can lead to muscle weakness in the affected arm, which may affect grip strength or the ability to lift objects.  While muscle weakness can be seen with rotator cuff problems these signs are limited to the shoulder.  Cervical problems can cause muscle weakness as well of the biceps and triceps as well as the wrist and hand.

If you’re having difficulty determining the source of your arm pain, it’s essential to seek medical evaluation from a healthcare professional, such as an orthopedic doctor or physical therapist. At Total Orthopedics and Sports Medicine we have specialists who can perform a thorough examination, possibly order imaging tests, and provide a proper diagnosis and treatment plan tailored to your specific condition.

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