Q: I am having a chronic problem that seems to go back and forth between my neck and my shoulder. It seems when one hurts the other one does not and vice versa. Why would this happen?
A: Neck pain can occur in conjunction with shoulder pain for many reasons. The simplest reason is that a muscle in the neck becomes overused or strained to the point that it develops a trigger point. Trigger points may develop in for instance the scalene muscles located at the lateral aspect of the neck on both sides that can cause symptoms that radiate into the shoulder even down the arm mimicking rotator cuff symptoms.
A trigger point in the levator scapulae muscle will cause symptoms in the shoulder blade. Treating the shoulder in this instance would be futile. The trigger points when addressed and eliminated will reduce all symptoms. So treating the neck specific to the trigger point will make neck and shoulder symptoms absent without even touching=2 0the shoulder.
Another possible explanation for neck and shoulder pain that would alternate would be involvement of a cervical disc. An injury that would weaken the ligaments of the capsule around the disc tissue between each vertebrae would allow the disc to protrude applying pressure to the nerve root and cause radiating symptoms that depending on which disc and how hard the disc was pushing on the nerve root will refer pain into the upper extremity. The more pressure the farther down the arm the symptoms will travel. If something should allow the pressure to decrease such as traction the symptoms would reduce and move back upward into the neck. A thorough evaluation can determine which of the two scenarios or if both of them are occurring at the same time.