Neck, Shoulder. Upper Limb Pain are a common problem with two-thirds of population having neck pain at some point in their lives. It is increasing in both intensity, frequency and severity of episodes.[citation needed] As people are increasingly sedentary, live fast-paced and hectic lives, they place more stress and strain on the upper back and neck regions of their spines.

Neck pain although felt in the neck, can be caused by numerous other spinal issues. Neck pain may arise due to muscular tightness in both the neck and upper back. Joint disruption in the neck creates pain as does joint disruption in the upper back.

The head is supported by the lower neck and upper back, it is these areas that commonly cause neck pain. The top three joints in the neck allow for most movement of your neck and head. The lower joints in the neck and those of the upper back create a supportive structure for your head to sit on. If this support system is affected adversly, then the muscles in the area will tighten, leading to neck pain. Neck pain may also arise from many other physical and or emotional health issues.

Neck Pain Causes

The reason why these happen is the complex area. Major and severe causes of neck pain include:

• Spondylosis - degenerative arthritis and osteophytes
• Spinal stenosis – a narrowing of the spinal canal
• Spinal disc herniation – protruding or bulging discs, or if severe prolapse.
• Severe degeneration – usually as a result of past injuries or whiplash accidents.
• The more common and lesser neck pain causes include:
• Stress – physical and emotional stresses
• Prolonged postures – many people fall asleep on sofas and chairs and wake with sore necks
• Minor injuries and falls – car accidents, sporting events and day to day minor injuries
• Referred pain – mostly from upper back problems
• Over-use – muscular strain is one of the most common causes

Although the causes are numerous, most are easily recitified by either professional help or using self help advice and techniques.

Shoulder structures and functions

The shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) (see diagram). Two joints facilitate shoulder movement. The acromioclavicular (AC) joint is located between the acromion (part of the scapula that forms the highest point of the shoulder) and the clavicle. The glenohumeral joint, to which the term "shoulder joint" commonly refers, is a ball-and-socket joint that allows the arm to rotate in a circular fashion or to hinge out and up away from the body. The "ball" is the top, rounded portion of the upper arm bone or humerus; the "socket," or glenoid, is a dish-shaped part of the outer edge of the scapula into which the ball fits. Arm movement is further facilitated by the ability of the scapula itself to slide along the rib cage. The capsule is a soft tissue envelope that encircles the glenohumeral joint. It is lined by a thin, smooth synovial membrane.

The bones of the shoulder are held in place by muscles, tendons, and ligaments. Tendons are tough cords of tissue that attach the shoulder muscles to bone and assist the muscles in moving the shoulder. Ligaments attach shoulder bones to each other, providing stability. For example, the front of the joint capsule is anchored by three glenohumeral ligaments.

The rotator cuff is a structure composed of tendons that, with associated muscles, holds the ball at the top of the humerus in the glenoid socket and provides mobility and strength to the shoulder joint.

Two filmy sac-like structures called bursae permit smooth gliding between bone, muscle, and tendon. They cushion and protect the rotator cuff from the bony arch of the acromion.

Origin and causes of shoulder problems

The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. It is easily subject to injury because the ball of the upper arm is larger than the shoulder socket that holds it. To remain stable, the shoulder must be anchored by its muscles, tendons, and ligaments. Some shoulder problems arise from the disruption of these soft tissues as a result of injury or from overuse or underuse of the shoulder. Other problems arise from a degenerative process in which tissues break down and no longer function well.

Shoulder pain may be localized or may be referred to areas around the shoulder or down the arm. Disease within the body (such as gallbladder, liver, or heart disease, or disease of the cervical spine of the neck) also may generate pain that travels along nerves to the shoulder. Conversely, pain felt in the region of the shoulder blade or scapula nearly always has its origin in the neck.

Treatment

Pain is treated by numerous physical therapies. They range in complexity depending on the severity and underlying causes of the pain. Treatment is administered by chiropractic, osteopathic and physical therapy. All of these specialties treat neck pain issues. The benefit of mobilisation and manipulation is not clear. Neck pain can also be eased via many self help techniques such as stretching, strength building exercises. Non-traditional methods such as Acupressure, Reflexology and therapeutic massage are commonly used as well.

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