Dr. B.R. Verma

The neck and shoulder have a huge range of movement and thus they are more prone to injury. The ball and socket joint at the upper arm is the shoulder and both the neck and the shoulder are made up of soft tissues, muscles and ligaments.

Reasons behind pain Injured rotator cuffs: 

Rotator cuffs are the tendons supporting the shoulder. If they are injured it might lead to a chronic loss of the range of movement. This is more commonly known as a frozen shoulder. 

1. Dislocation: Dislocated disc of the neck or shoulder due to an accident would cause severe pain in the affected area. 
2. Fractures: Fractured collarbone or the upper arm bone may result in chronic pain. 
3. Tendonitis: This occurs due to the over usage of the arms or neck or strains due to over exertion like in sports. 
4. An unstable shoulder joint: If there is instability in the ball and socket joint of the upper arm, chances of having a chronic pain is high. Others: Degenerative arthritis, herniated disc, and even heart attacks can be the other possible causes of chronic neck and shoulder pain. 

When to go to the doctor? 

When the patient experiences a pain due to a severe blow or injury, the neck pain radiates down the legs and arms, a feeling of numbness and tingling sensation, or has a stiff neck with fever or vomiting, it is essential to seek the advice of a Doctor. 

Diagnosis for shoulder and neck pain X-ray: 

The main form of diagnosing a pain is an x-ray. It helps to reveal diseases from arthritis, tumour, slipped disc, narrowing spinal cord, fractures and spinal cord instability. 

1. MRI: Magnetic Resonance Imaging or simply the MRI reveals the detail of nerve-related issues along with the problems in the ligaments and tendons. 
2. CT scan: There may be instances when the injuries are difficult to be diagnosed. And, in the case of a fracture, a CT Scan is advised for more details. It is also an alternative to MRI. 
3. ECG: An Electrocardiogram is a way of diagnosis if shoulder and neck pain continues along with chest pain or shortness of breath. If there is a risk of an individual having a heart attack, then an ECG is recommended. 
4. Electro Diagnosis: Electromyography referred to as EMG and Nerve Conduction Velocity (NCV) are used to diagnose pain in the arm, neck, shoulder followed by a numb feeling on the affected areas. 

Treatment for chronic shoulder and neck pain 
A simple sprain on the neck and shoulder would demand a rest for a few days along with pain medication. If the pain is due to muscle spasms application of dry or moist heat may provide relief. In the case of a swelling due to injuries, a cold ice pack 4 to 8 times a day will provide immense relief. Patients might be advised a cast or sling for the shoulder pain. The soft tissues in the neck and shoulder can be treated with pain relievers taken for a few days. Muscle relaxants are also prescribed depending on the severity of the pain. Local corticosteroid injections are helpful for shoulder arthritis. Platelet rich plasma injection is another modern treatment for arthritis or tendinopathy. In some situation, radio frequency procedures are very helpful. Exercises are very effective for both neck and shoulder pain movement. Surgery might be an option if nerve roots are affected.