When people present with pain localised to the neck it is easy to determine that the most likely source of the patients’ symptoms is their cervical spine. Where is gets slightly more confusing is when the location of the pain spreads out from the shoulder into the upper trapezius, scapula, into the neck and down the arm. The patient will often complain of “shoulder” pain however on many occasions, the true source of the patients’ symptoms is in fact the cervical spine.


How to tell if it is a neck or shoulder issue from the history

True shoulder pain:

  • Pain localised in the shoulder/upper arm.
  • Nil pain at rest, unless aggravated from recent movement.
  • Range and strength loss only in the shoulder.
  • History and mechanism of injury specific to the shoulder.


Cervical spine pain referring to the shoulder:

  • Insidious onset – no apparent reason.
  • Scapular and upper trapezius region pain.
  • Shoulder pain at rest without recent shoulder movement.
  • Prolonged sitting aggravates shoulder pain.
  • No loss of shoulder range of motion.