NECK OR SHOULDER PAIN MIGHT ORIGINATE IN THE MIDDLE OF THE BACK

Bad posture habits can lead to various problems including neck and/or shoulder pain. In today’s society, almost everyone is “attached” to their phones, computers or notebooks.  Everyday people all across our society, repeat bad posture habits by looking downward at a screen of some kind to search the internet, view applications and web pages, respond to emails or send texts.  This posture can lead to a host of problems that can negatively affect the neck or shoulders.

The neck muscles are capable of controlling the head in the forward flexed position but some of the middle and upper back musculature might not be conditioned well enough to provide the necessary support. Likewise, these same muscles might not control the scapula (shoulder blade) when the arm is moving and numerous painful shoulder conditions can occur secondary to the lack of control.

The cervical spine has musculature that originates in the thoracic spine which is the area where the ribs are and the scapulae are attached.   Many conditions can lead to dysfunction in the thoracic spine and cause the musculature to “work over-time,” which leads to muscle fatigue, cramping, and pain.  If the thoracic spine, does not move correctly due to restrictions in motion in the joints of the spine, the restricted movement leads to a need for more muscle energy and force to move the joint.  This can lead to abnormal muscle contraction in the mid back and neck region.  The abnormal muscle demand can cause pain to occur due to muscle fatigue, cramping and the development of trigger points or “knots” in the muscles.

The shoulder joint consists of the clavicle (collarbone), scapula (shoulder blade) and humerus (arm bone) and all three have to move together to enable someone to use their shoulder joint and not develop pain.  The shoulder blade or scapula plays an extremely important role in the synchrony of motion within the joint. If the scapula is not stable during arm motions, there is a strong possibility that there will be dysfunction in the joint and this usually leads to a painful shoulder or worse. The humeral head is round and articulates on a saucer-shaped glenoid fossa which is a part of the scapula and located in the “armpit” area.  As the arm moves the round ball must remain on the fossa and the scapula must remain stable but move in synchrony with the humeral head.  The stability of the scapula is determined by the strength and condition of the mid and upper back musculature.  These muscles help to control the scapula’s motion and make it a stable anchoring location for the rotator cuff muscles and keep the fossa and humeral head aligned.

Physical Therapists are trained to evaluate the status of the thoracic spine and make sure it is moving properly.  If there is dysfunction in this area for any reason, the Physical Therapist will develop a treatment plan that will restore the normal motion and reduce the probability of developing a painful neck or shoulder.   You do not have to see a doctor prior to seeing a Physical Therapist because you are not required to have doctor’s prescription for Physical Therapy services. Check with your insurance company because your policy might require you to secure a referral form your general practitioner for Physical Therapy services.

Neck and shoulder pain can have many origins. Healthcare professionals must identify that origin correctly, or they will treat a symptom and not fix the true “problem.” The thoracic spine has to move properly and the muscle structure in the thoracic spine must be strong and conditioned well enough to support the spine and control the scapula or a dysfunction can occur in the shoulder joints or neck leading to a host of problems.