Causes of neck pain include abnormalities in the bone or joints, trauma, poor posture, degenerative diseases, and tumors. Pain in the soft tissues (muscles, tendons, and ligaments) is the most common cause of neck pain and usually occurs as a result of an acute or a chronic muscle strain. The neck is very mobile, which means it is less stable than other areas of the body and more easily injured.

The shoulder is a ball and socket joint with a large range of movement. Such a mobile joint tends to be more susceptible to injury. Shoulder pain can stem from one or more of the following causes:

• Strains from overexertion
  
• Tendonitis from overuse
• Shoulder joint instability.
  
• Dislocation
  
• Collar or upper arm bone fractures
  
• “Frozen” shoulder
  
• Pinched nerves (also called radiculopathy)
  

• X-rays can be helpful in diagnosing neck and shoulder pain. Plain X-rays can reveal disc space narrowing, rheumatologic disease, destructive lesions, slippage, stenosis, fractures, and instability with flexion-extension views.
• Magnetic resonance imaging (MRI) is a non-invasive procedure that can reveal the detail of neural (nerve-related) elements.
  
• Myelography/CT scanning is sometimes used as an alternative to MRI.
  
• Electrodiagnostic studies—electromyography (EMG) and nerve conduction velocity (NCV)—also might aid in the diagnosis of neck and shoulder pain, arm pain, numbness, and tingling.
  

The treatment of soft tissue neck and shoulder pain includes the use of anti-inflammatory medicine and/or Panadol  (acetaminophen). Pain also might be treated with a local application of moist heat or ice. A local corticosteroid injection is often helpful for arthritis of the shoulder. For both neck and shoulder pain movement exercises can have positive results. For cases in which nerve roots or the spinal cord are involved, surgical procedures might be necessary.