Shoulder problems can be a real pain in the neck!
Neck and shoulder pain often go together. Many patients come to see Dr. Burns for shoulder pain and are surprised to find that they actually have a “pain in the neck.” Occasionally, patients can have no neck pain but rather pain that radiates down into their shoulder, shoulder blade, arm or hand. This can also be accompanied by numbness or tingling. This type of pain is called referred pain because the pain is felt in a different location than the source of the pain. This is due to inflammation and pain from a “pinched nerve” in the neck. This type of pain and inflammation is often accompanied by muscle spasm and tightness in the neck, traps, shoulder blades and shoulders.
Start feeling better!
You can start feeling better by using medication, heat, stretching, and products that support and care for your neck. Physical therapy and prescription medications can also help to relieve this type of pain.
Please contact Dr. Burns at 314-291-7900 if you complete your course of non-operative treatment and do not feel better. Dr. Burns is not a neck surgeon or a neck specialist; however she can obtain a cervical spine MRI and refer you for additional treatment. This would include referral to a spine surgeon or a non-operative specialist, such as a physiatrist or pain management specialist who can perform neck injections.
Medications
Dr. Burns will select the appropriate medications from the list below.
Steroid Anti-inflammatory. This is a powerful anti-inflammatory that you will take for less than a week. Follow the instructions on the package; taking 6 pills the first day, then 5 pills, etc. This medication will reduce the inflammation and swelling around the inflamed nerve or nerve root.
☐ Medrol dose pack
Non-Steroid Anti-Inflammatory. This is an anti-inflammatory medication that you should start after you finish the steroid medicine, if you were prescribed a steroid. This medication can irritate the stomach, so take it with food, and follow the directions on the package.
☐ Ibuprofen (Motrin), 800 mg three times a day.
☐ Naproxen (Aleve) 500 mg twice a day.
Muscle Relaxant: This will help with muscle spasm and tension. This medication can make you drowsy, so it is best to start by taking this medication at night. You can then increase it as tolerated and as necessary to 2-3 times per day.
☐ Cyclobenzaprine (Flexeril) 5-10mg as needed up to 3 times a day.
☐ Tizanadine (Zanaflex) 4 mg three times a day as needed.
Tylenol: This is a medication to help with pain.
☐ Tylenol (over the counter) 500-1,000 mg three times a day as needed
Home exercises
Start these simple home stretches below. Perform these stretches twice a day, beginning in the evening, after you have taken your medication and placed 20 minutes of heat on your neck muscles. Also stretch in the morning after a hot shower or bath. Your physical therapist will also add additional stretches after you begin therapy.
Stretch by bringing your ear to the side of your neck. Use your hand to gently pull to your ear to your shoulder, stretching the opposite side. Hold for 5 seconds. Perform 3-5 times on each side.
Perform the above stretch at a 45-degree angle, bringing your chin down toward your chest. Hold for 5 seconds, and perform 3-5 times on each side. Use your hand on your head to gently pull and deepen the stretch.
Chin Tuck. Sitting upright in a chair, press your chin straight back and hold for 3 to 5 seconds; repeat 10 times.
Products we love!
Apply heat to your neck in the evenings before stretching. We like a fitted cervical heating pad, a microwaveable neck pad or the Elasto-gel neck wrap. These products will fit better around your neck and heat the tense neck muscles and spasms that tend to go along with neck pain and arthritis.
Dr. Burns recommends that you try a memory foam contour pillow such as Sutera. These pillows can be found on Amazon or at Target. They have a gentle cradle for your neck to support the curve. You can use this pillow under your regular pillow if necessary until you get used to the new, supportive curve. A pillow like this is useful for back and side sleepers.