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When someone comes for physiotherapy reporting shoulder pain, the physiotherapist’s first job is to determine if the pain is coming from the shoulder or if it actually is a neck problem. The nerves and muscles that provide sensation and movement to the shoulder region and the whole arm come from the neck. If there is a problem with the neck, such as inflammation, degenerative changes or a disc prolapse, pain can be referred from the neck, to the shoulder by these nerves. You may feel no pain in the neck, just pain in the shoulder. It can be difficult for you to tell if the pain is coming from the neck or shoulder. Your physiotherapist will take a detailed history and conduct a physical examination to determine where the pain is coming from.
If your physiotherapist diagnoses a neck dysfunction as the cause of your shoulder problem, treatment will focus on correcting this neck dysfunction. This may include manual therapy to the joints of the neck to restore movement or dry needling the muscles of the neck to relieve pain. With any neck problem, posture is of great importance. Your physiotherapist will provide ergonomic advice on how to set up your work station correctly and improving your posture. Strengthening exercise for the neck and shoulder muscles is also important to maintain improvements.