Shoulder Pain That Won’t Heal? The Real Problem May Be in Your Neck

Shoulder injuries are among the most common complaints I see in my practice, often affecting athletes, labourers, and even desk workers. But while most therapists and doctors focus exclusively on the shoulder itself—prescribing endless exercises, physical therapy, or even surgery—many fail to ask a critical question: Is the real problem coming from the neck?

I was reminded of this just this past weekend when my son experienced pain and weakness in his right shoulder after overtraining. His shoulder wasn’t just sore—it was dropping, unable to hold proper position. It immediately brought to mind another case I saw years ago: a young swimmer, facing the same problem. Her shoulder was weak, losing power, and despite months of physical therapy, nothing changed. Surgeons were beginning to talk about operating. But when I examined her, I found the real culprit: interference in the nerves coming from her neck, specifically affecting the rotator cuff muscles.

A simple adjustment to the cervical spine, restoring normal nerve flow, and within two weeks, she was back in the water at full strength.

The Overlooked Link Between the Neck and Shoulder Dysfunction

The rotator cuff muscles—supraspinatus, infraspinatus, teres minor, and subscapularis—are all directly controlled by nerves originating in the cervical spine (C3-C6, particularly the suprascapular and axillary nerves). If those nerves are irritated, compressed, or misaligned due to spinal dysfunction (commonly seen in athletes, people with poor posture, or those who have experienced trauma), then the shoulder won’t function properly—no matter how much you stretch or strengthen it.

A 2016 study published in the Journal of Orthopaedic & Sports Physical Therapy found that cervical radiculopathy (nerve compression in the neck) can mimic rotator cuff injury symptoms—including weakness, pain, and even atrophy. (1) This means that if the underlying neck issue isn’t addressed, standard shoulder rehab is doomed to fail.

Why This Matters for Athletes and Active Individuals

Athletes are especially vulnerable to this type of problem because of repetitive strain. Swimmers, baseball players, weightlifters, and tennis players all place immense stress on their shoulders, but the hidden factor is often the neck—especially if they have a history of whiplash, poor posture, or long hours in front of screens.

Traditional shoulder rehab—focused on stretching, band exercises, and rotator cuff strengthening—misses the mark if nerve interference from the neck isn’t addressed first. In many cases, this leads to:

✅ Prolonged recovery times (months of therapy with no improvement)
✅ Recurrent injuries (because the real problem was never fixed)
✅ Unnecessary surgeries (when the issue was neurological, not structural)

How to Identify a Neck-Related Shoulder Problem

If you or someone you know has persistent shoulder pain, weakness, or a dropped shoulder that isn’t improving, consider these signs that the neck may be involved:

✔️ Pain or stiffness in the neck along with shoulder discomfort
✔️ Weakness in the rotator cuff muscles without a clear injury
✔️ Numbness, tingling, or burning sensations down the arm
✔️ Previous neck trauma (whiplash, sports injuries, poor posture)
✔️ Failure to improve with standard shoulder rehab

The Bottom Line

Before resorting to invasive treatments like cortisone injections or surgery, the cervical spine must be assessed. In many cases, a chiropractic adjustment to restore proper nerve function can lead to rapid improvements in shoulder strength, stability, and pain relief—often in a matter of weeks, not months.

Athletes and active individuals deserve better than incomplete diagnoses and endless rehab routines that don’t address the root cause. If the shoulder problem won’t heal, it’s time to look at the neck.

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References: 1.Global Spine Journal. 2019 Feb 17;10(2):195–208– “Overlapping, Masquerading, and Causative Cervical Spine and Shoulder Pathology: A Systematic Review” (Link)