Can Children’s Shoulder Pain Really Originate from the Neck?

Shoulder pain is the ‘new’ common complaint among children, particularly during adolescence. Some causes of shoulder pain in young people include poor posture, inappropriate forms of exercise and carrying heavy schoolbags. However, if the pain is persistent, and felt in the same place, take your child to see a specialist. Since children with shoulder pain may become adults with a potentially permanent condition, it is important to encourage sensible back care in young people.

A 2012 study from the Indiana-based National Posture Institute found about 38 percent of children between the ages of four and 12 demonstrate poor posture—how do parents know when a bad habit becomes a real problem such as chronic shoulder pain?

Most shoulder pain results from an injury or condition in the shoulder itself. However, sometimes shoulder pain stems from a problem in the neck.  When a nerve root in the cervical spine (neck) is irritated, the symptoms can radiate into the shoulder, arm, and hand.  There are eight nerve roots branching from each side of the cervical spine in the neck, and they’re labelled C1-C8. Nerve roots C3 – C8 all pass through a specific part of the shoulder.  If a cervical nerve root becomes compressed or irritated in the neck, it can cause pain and symptoms that radiate along the path of the nerve into the shoulder, arm and/or hand. This is described as ‘cervical radiculopathy’.  In other words, pain radiating to your shoulder and arm however the source of the problem originates from the neck.

Radicular pain and accompanying symptoms can vary and include any or all of the following:

  • Pain that feels that ranges from dull to sharp or severe
  • Pain that is intermittent, or sometimes constant and unrelenting
  • Pain that stays in the same area (such as the shoulder blade) or pain that radiates along the nerve and could go from the shoulder down the arm to the hand
  • A ‘pins-and-needles’ sensation, which could be in one spot or radiate through the shoulder and into the arm
  • Weakness or numbness in the shoulder and/or arm, which could be constant or sporadic

Some research indicates that if shoulder pain symptoms tend to develop with the following pattern:

  • C5 radiculopathy tends to lead to pain in the upper shoulder near the neck and could either be sharp pain on the surface or a deep, achy pain
  • C6 radiculopathy would be more on the outer shoulder and likely a pain that feels closer to skin level
  • C7 radiculopathy would be the inner part of the shoulder closer to the spine and would likely have pain that feels surface-level rather than deep
  • C8 radiculopathy, which is less common than the others, would be the lower shoulder and could have pain that is either sharp on the surface or deep and achy

Several common neck problems can cause symptoms of cervical radiculopathy, including:

  • Cervical degenerative disc disease. The intervertebral discs between the vertebrae lose hydration over time. When a disc loses enough hydration it becomes thinner and less able to do its job, potentially producing pain and possibly irritating or pressuring on the nearby nerve root.
  • Cervical herniated disc. Each intervertebral disc contains a hard outer layer and soft inner layer. If the outer layer gets a tear that allows the inner gel to leak out, that can inflame and/or irritate the nearby nerve root.
  • Cervical osteoarthritis. When a facet joint in the neck becomes arthritic, the inflammation and excess bone growth can alter the joint’s size and spacing, which could result in a nerve root being irritated or impinged.
  • Cervical foraminal stenosis. This condition occurs when the nerve root becomes compressed while going through the foramen—a small hole in the bony vertebral construct. The narrowing of the foramen can happen in various ways, such by the overgrowth of bone spurs or by a herniated disc.

Correcting your posture may feel awkward at first because your body has become so used to sitting and standing in a particular way.  Get into the habit of sitting correctly. It may not feel comfortable initially because your muscles have not been conditioned to support you in the correct position.   With a little practice, good posture will become second nature and be one step to helping your back in the long term.  Remember, mastery comes through (conscious) repetition.
-Lawrence Woods