Shoulder pain can begin with the scalene muscles which attach from most of the neck vertebrae to the first and second ribs.
In between this series of three muscles on each side of the neck are the nerves, arteries and other vessels that lead to your hands. If these muscles are in a spasm they can cause trouble from the neck to the fingers, most commonly pain from root of neck to shoulder blade and chest.
A supraspinatus (top of the shoulder) muscle spasm can send pain to the side of your shoulder and down your arm.
The trapezius muscle runs from the bottom of your skull, along the backs of your collarbones, attaches to your shoulderblades and spans your back, ending in a point in your midback. It rests on and affects most muscles in your upper/midback and shoulders. Spasms of this muscle can cause headaches, shoulder, back and arm pain.
One of the symptoms of gall bladder distress is a sore right shoulder.
How did we get the pain?
The neck is the most unprotected part of the spine. It's the most mobile area... and the muscles are smaller than elsewhere. Your neck also compensates for misalignments further down your spine and even in your feet.
If the arches are flat, the structure of the foot is off balance. The bottom ends of your two shin bones form an ankle and articulate with the feet; the top of your tibia or larger shin bone articulates with the femur or thigh bone, with the hip and then the low back, on up to the neck.
Subluxations of the cranial or neck bones can affect anything below or above. Don't forget, muscles are attached to bones. Muscles move bones. If the muscles spasm they will pull the bones out of alignment.
Our teeth can cause mega shoulder pain. Sometimes a low-grade infection from a root canal or an abscess can refer pain to shoulders. Holding your mouth open for long periods of time in the dentist's chair can affect your tempromandibular joint, muscles and become a pain in the neck.
Holding your head in a position that isn't neutral for a long time can cause shortening of some muscles and stretching of others. For instance, if you grip the phone receiver between your shoulder and ear, the muscles on that side of your neck will shorten because they've been in that position so long. Phone headsets are very inexpensive these days. Remember when you were a child and those crazy people told not to make faces because your face would freeze in that position. Guess what.....don't make faces or hold the phone receiver between your ear and shoulder....you'll freeze that way.
Another no-no is sleeping on your stomach.(This is my favourtite position but I do struggle with my neck I must admit). Our head has to turn either left or right and stay that position for hours at a time. If your hearing in one ear is off, you may find yourself constantly tilting your head in the direction of sounds. People who carry or wear a heavy shoulder or handbag tend to lift that shoulder a push it forward. TMJ or tempromandibular joint syndrome and teeth clenching or grinding can cause neck and shoulder pain, too. An upper respiratory infection can reveal itself with a "stiff neck" because the throat and some neck muscles share a nerve segment.
One of the most common and most bothersome reasons is the "whiplash". Whiplash is usually a flexion/extension injury (meaning you were forced forward then backward without a chance to protect and control your movement). Results often are sprain/strain of muscles and ligaments. Note: Sprains are stretching and/or tears in ligaments which hold joints together. A strain is stretching and/or tearing of muscle. A sprain will always hurt. A strain usually hurts more with movement.
Often it takes about six weeks for your connective tissue to begin to heal after injury. If your vertebrae aren't aligned before this, they may stay in a semi-permanent state of subluxation, bound by connective tissue (that white stuff that surrounds muscles and doesn't stretch much).
Proper sleeping positions help, too. Sleep on your back with a large pillow under your knees and a small roll under your neck; or on your side with a pillow between your bent knees and a larger pillow under your head. Head and neck should be lined up as though you are standing, in a neutral position.
Heat, ice, far infrared saunas and all those rubs have their places in dealing with necks and shoulders. Don't do anything that hurts more than helps. Heat or cold can help or sometimes aggravate pain. For a problem that was already diagnosed as musculoskeletal in origin, try cold first, it won't cause swelling; cover your skin with cloth to help prevent frostbite. Don't keep ice on your body more than 15 minutes at a time. If ice doesn't do it, try heat, not more than 20 minutes. Be careful not to burn yourself and don't sleep with a heating pad on.