The most commonly missed type of Shoulder Pain is pain that is referred from the neck to the shoulder.

Referred pain is when you feel pain somewhere but the pain is coming from somewhere else. Pain that is under the shoulder blade that you can’t reach or touch is a classic example of the referred pain phenomenon. This pain is actually being referred from a disc in the lower neck! And, to top it all off, you typically don’t feel any pain in your neck at all, even while moving your neck. Crazy right!

As you can see, the nerves leaving your neck go right in front of your shoulder blade, which is why you can feel pain here from a disc injury in your lower neck.

How do you know that this deep, shoulder blade pain is coming from the neck? Its actually quite simple, performing a traction test to the lower neck determines if the lower neck is involved. If the test relieves the pain or you feel the pain move out of your shoulder blade towards you mid back or neck, then the pain is coming from the neck and NOT the shoulder.

Also, you will most likely NOT see anything on MRI or x-ray imaging studies. Fortunately, proper history, physical exam, and orthopedic testing can figure out more spine and joint injuries without imaging being necessary.

I hope this information helps! This is a very common presentation I see in my office because most doctors and PT’s miss diagnose this patient and treat it as a shoulder problem instead of a neck problem. If this email describes you or someone you know, don’t hesitate to call my office so I can help!

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