Part of Shoulder impingement
Shoulder impingement and neck pain: can one cause the other?
Warning signs, and when to get help
Can shoulder impingement cause neck pain?
Yes, in a roundabout way, and the route matters more than the answer. The descriptions patients are given for this problem keep the pain in the shoulder and the arm. OrthoInfo puts the pain and tenderness at the front or side of the shoulder and takes it from the front of the shoulder down the side of the arm. Neither that page nor the NHS page on shoulder pain describes the pain spreading up into the neck, and the NHS page does not name the neck as a cause of shoulder pain anywhere on it.
What we see in clinic is different from spread. A neck gets sore alongside a shoulder that has quietly stopped doing its share of the work, which is a second problem rather than the first one traveling, and most of this page is about telling those apart.
The name is its own small obstacle. Guidelines have largely dropped the word impingement, so your letter may say subacromial pain syndrome, which is the name the Dutch Orthopaedic Association guideline uses (Diercks and colleagues, 2014), or rotator cuff related shoulder pain, or rotator cuff tendinopathy. Same shoulder, different vintage of name, and the shoulder impingement program sets out the change and why it happened. The rotator cuff tendinopathy page goes further into the tendon itself.
Where subacromial shoulder pain is usually felt, and how far it spreads
OrthoInfo describes pain and stiffness when you lift the arm and reach above your head, pain on the way back down, pain that is typically at its worst at night, and tenderness at the front or side of the shoulder. The NHS files impingement, along with tendonitis and bursitis, under shoulder pain that is worse while you are using the arm. Shoulder pain when lifting your arm goes through the lift itself and which part of it hurts.
Now read that description again for what is missing. The neck is not there. Nothing in it reaches the forearm or the hand.
So a pain whose center sits up where the shoulder meets the neck, or between the shoulder blades, is already behaving unlike the descriptions above. That does not make it a neck problem. Two other things live in that small patch: the joint where the collarbone meets the shoulder, which has its own pattern and its own AC joint page, and the muscles running from the neck down to the shoulder blade. Being able to put a finger near the middle of your pain, and say what changes it, is worth more at an appointment than any name.
Can a neck problem look like shoulder impingement instead?
This is the direction the sources actually describe. The NHS page on cervical spondylosis, the age-related changes in the bones and discs of the neck, names neck and shoulder pain or stiffness that can come and go as its symptom. Not neck pain, with shoulder pain as a complication. The two of them together, as the ordinary way it turns up.
An irritated nerve root in the neck does something different again, sending pain, numbness, tingling or weakness along the path of that nerve down the arm, often with pain around the shoulder blade. That is cervical radiculopathy. OrthoInfo says a doctor assessing a shoulder like yours may examine your neck to make sure the pain is not coming from a pinched nerve there, and the fact that this sits on the shoulder page and not the neck page tells you how routine the mix-up is.
Two more candidates sit close by. Pressure at the base of the neck and under the collarbone belongs to thoracic outlet syndrome, and pain that starts in the neck and ends up as a headache belongs to cervicogenic headache. If your neck pain is firmly on one side, neck pain on one side covers the rest of the list, including the causes that have nothing to do with muscles or joints at all.
Is my shoulder pain coming from my neck?
Nothing you can do at the kitchen table settles this, and the tests circulating online are clinician tests being used out of context. What helps is turning up able to describe four things clearly, because that is what the examination is built on.
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What your head does to it. Most people already know this without testing anything: whether the pain bites when you reverse the car, turn to speak to a passenger, or look up at a high shelf. Pain that changes while the arm hangs still is behaving like a neck. If a neck movement makes you dizzy, stop, sit still until it settles, and get medical advice the same day before you try again.
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What your arm does to it. Pain that waits until the arm is on its way up, then shows up in a band of the movement, is behaving like a shoulder.
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Where it has its center, and where it stops. Front or side of the shoulder and down the outside of the upper arm, against a stripe from the base of the neck out over the shoulder blade, are two different stories.
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Whether anything is numb, tingling or weak. That is not a feature of a sore tendon, so say it out loud at the appointment instead of trying to place it yourself, and the warning signs at the end of this page say how quickly.
Even the guideline writers found this hard. The Dutch working group recorded that in the literature they reviewed, the difference between subacromial complaints and general pain in the shoulder or neck was not always clear (Diercks and colleagues, 2014). If the published studies could not reliably separate the two, nobody should expect you to do it on your own at home.
Why the neck gets sore when the shoulder will not lift
Here is the pattern we see most, with the honest label on it first: this is clinical observation, not a settled mechanism. A shoulder that hurts partway up a lift gets helped along. It hitches toward the ear as the arm rises, a habit the shoulder impingement program describes alongside the other one, which is that the arm quietly stops being used for the kettle and the top shelf. The muscles doing that extra work run from the neck and the shoulder blade, and they ache like any muscle asked to do a job that is not theirs.
No study we can point to shows that this is why a neck gets sore in a person with a painful shoulder, so treat it as a pattern worth checking rather than an explanation to lean on. Posture is a separate argument, and a less convincing one than people expect; the parent page answers it from the reviews and not from opinion.
The useful part of all this is that the shoulder blade is shared ground: the lying shoulder blade press and seated thoracic extension open the impingement program, while the neck pain program builds toward the same muscles between and below the shoulder blades and starts with the chin tuck. And if the shoulder blade itself is the part that will not behave, scapular dyskinesis is the page for that, while pain between the shoulder blades covers that spot and the patterns there that need faster help. For long days at a screen, neck and back pain when working from home is where the desk belongs.
What about pain down to the elbow?
An ache that spreads into the upper arm fits the pattern. OrthoInfo takes the pain from the front of the shoulder to the side of the arm, so a heavy, sore arm halfway to the elbow is not a surprise and does not mean something new has gone wrong.
Below the elbow is a different question. The descriptions of this condition do not carry pain into the forearm, the hand or the fingers, and pins and needles, numbness and weakness are not features of an irritated tendon. Numbness, tingling and pain down the arm covers that properly, including what else produces it and how urgently each one needs looking at.
What to do when both are sore
Treat it as one plan with two parts, not a choice between two plans. A physio works out which of the two is driving your symptoms now, starts there, and brings the other in as it allows. That is a sequence, and it is not a decision you have to make before the first appointment.
Your part is easier than it sounds. Say plainly that both areas are sore instead of naming the louder one, because a shoulder described on its own gets a shoulder assessment. Judge each area on its own response too: the impingement program's rule for what counts as acceptable discomfort, when to stop an exercise and when to drop back a step, is on the parent page and applies to the shoulder work whatever the neck is doing.
There is one clash to know about in advance. The stretch handed out most often for the top of the shoulder, the upper trapezius stretch, tips the head away from the sore side and holds it there, and our pinched nerve program deliberately leaves that family of stretches out while an arm is irritable. Stop any stretch that brings tingling into your arm or hand. The other neck pages are grouped together under neck conditions if you want to read around it, and stiff neck after sleeping covers the mornings.
When neck and shoulder pain together needs checking
The NHS advises getting medical help if shoulder pain has not started to feel better after 2 weeks, and seeing a doctor if it is getting worse or it is very hard to move the arm. Go sooner if you cannot tell which end your pain is coming from. A single assessment can save you months of exercises aimed at the wrong end. The NHS adds that in many areas you can refer yourself to an NHS musculoskeletal physiotherapy service without a doctor's referral, and a physio or physical therapist is the right person to sort out a neck and a shoulder together.
A couple of arm symptoms do not belong in this comparison at all. If you have pins and needles in an arm together with neck or arm pain, or your arm feels heavy or weak, the NHS advises asking for an urgent GP appointment or calling NHS 111. Wherever you live, get it checked the same day if nobody has looked at it yet.
One kind of neck pain is not a neck pain problem. A new headache or neck pain that does not feel like your ordinary neck pain has its own lines on the list below, and the two things that matter are whether it arrived in a single moment and whether anything you do changes it. Either on its own is enough to be seen, and it matters more if it followed a strain, a bout of heavy coughing or having your neck manipulated. Until it has been checked, do not start neck exercises and do not have hands-on treatment to your neck. The warning signs below each carry their own time frame, and several of them need help today, not an appointment next week.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: any sign of a stroke, even if it goes away. That means a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, sudden dizziness with unsteadiness or falling over, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack). Call emergency services straight away. With neck pain, these can rarely come from a tear in an artery in the neck.
- Emergency: a new headache, or new pain on one side of your face, jaw or neck, with a drooping eyelid or a smaller pupil on the same side, or with a new pulsing or whooshing sound in one ear that keeps time with your heartbeat. Call emergency services or go to an emergency department straight away, and do not drive yourself. This can be a tear in an artery in the neck (cervical artery dissection), which can lead to a stroke.
- Emergency: a sudden, severe headache or neck pain that feels new and unlike anything you have had before. Call emergency services straight away.
- Emergency: a new headache or neck pain, or both, that does not feel like ordinary neck pain. If this is your first bout, judge it by how it behaves rather than by how it compares. Either of the next two is enough on its own. One, it came on suddenly, in a single moment, even if it is not severe and even if it has eased since. Sudden onset counts on its own. Two, nothing you do changes it much: no position or rest makes a real difference, and after the first day or two it has not started to settle. It counts even if you have none of the other emergency signs above, and it matters more if it started after a neck injury or strain, even a minor one, a bout of heavy coughing, or having your neck manipulated. Go to an emergency department straight away, or call emergency services if you cannot get there safely, and do not drive yourself. Do not start these exercises, and do not have any hands-on treatment to your neck, until your neck has been checked. A tear in an artery in the neck can start as pain alone, often on one side, with nothing else to find. If you can find a position that eases it, follow the same day warning sign for this below instead.
- Chest pain or tightness, which may spread to your arm, neck or jaw, or shoulder or arm pain that comes with shortness of breath, sweating or feeling sick. This can be a heart attack. Call emergency services straight away.
- Your arm, hand or fingers turn cold, pale, blue or gray compared with the other side. Call emergency services or go to an emergency department straight away, and do not drive yourself. The blood supply to the arm may be blocked.
- Emergency: new problems walking, for example your legs feel stiff, heavy or weak or you have become unsteady on your feet, new trouble controlling your bladder or bowels, or hands that suddenly become clumsy, for example you can no longer do up buttons. Call emergency services straight away. These can be signs of pressure on the spinal cord in the neck.
- Emergency: a stiff neck with a fever, a severe headache that is getting worse, pain when you look at bright lights, confusion, or a rash that does not fade when you press a glass on it. Call emergency services. These can be signs of meningitis.
- Emergency: you have had cancer, now or in the past, and your back or neck pain feels like a tight band around your body, or comes with pain spreading down an arm or leg, weakness, numbness or pins and needles in your arms or legs, trouble walking, or trouble controlling your bladder or bowels. Call your cancer team's emergency number straight away, or go to an emergency department if you do not have one or cannot get through. This can be cancer pressing on the spinal cord (metastatic spinal cord compression), which needs treatment straight away.
- The shoulder feels as if it has slipped out of place, looks a different shape or suddenly locks so you cannot move the arm, or the pain is severe after a fall or an injury. Go to an emergency department straight away, without driving yourself, and do not try to put the shoulder back in yourself.
- The shoulder is hot, red and swollen, or you have a fever or feel unwell. This can be a joint infection, which needs treatment quickly. Go to an emergency department the same day, and call emergency services if you feel very unwell.
Get help today
- A new headache or neck pain, or both, that does not feel like ordinary neck pain, that started after a neck injury or strain, even a minor one, a bout of heavy coughing, or having your neck manipulated, but that does ease when you change position or rest. Get checked the same day before you start these exercises or have any hands-on treatment to your neck. If nothing you do changes it much any more, or it has not started to settle after a day or two, follow the emergency warning sign for this above.
- Hands that have slowly become clumsy, for example trouble doing up buttons or dropping things, or numbness in both hands. Get medical advice the same day. These can be signs of pressure on the spinal cord in the neck (cervical myelopathy). If the clumsiness or numbness gets worse quickly, call emergency services straight away.
- Pain or tingling in both arms at the same time, rather than in one. Get medical advice the same day. This can also be a sign of pressure on the spinal cord in the neck.
- Pins and needles in an arm together with neck or arm pain, or an arm that feels heavy or weak, and nobody has checked it yet. Get medical advice the same day.
- An arm or hand that is getting weaker. Get medical advice the same day.
- An electric shock feeling runs down your back or into your arms or legs as your head bends forward. Stop and get medical advice the same day.
- Severe neck or arm pain that comes on suddenly or is getting worse quickly, without any of the emergency signs above. Get medical advice the same day.
- Sudden, very bad shoulder pain, or you suddenly cannot lift or move your arm at all. Get medical help the same day.
- The pain started after a fall, a pull or another injury, especially if the arm has been weak since, for example you cannot lift it out to the side or hold it up. This can be a broken bone or a torn tendon. Get medical advice the same day, and say how it happened and that the arm has been weak since, because UK shoulder surgeons advise urgent referral for a rotator cuff tear caused by an injury.
- Dizziness, a spinning feeling or feeling sick that comes on when you turn or tip your head, without any of the emergency signs above. Stop the exercises and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
- Neck pain with a fever or chills, or you feel generally unwell. Get medical advice the same day, and go to an emergency department if you feel very unwell.
- New neck, shoulder or arm pain and you have had cancer, now or in the past, or you have lost weight without trying. Get medical advice the same day and mention it. If you are being treated for cancer now, contact your cancer team the same day.
- Pain at night or at rest that is constant, that no rest or change of position eases at all, and that keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.
- Severe pain in both shoulders that has come on recently. Get medical advice the same day.
- You are over 50 and have aching and stiffness in both shoulders, often in the neck or hips too, that is worst in the morning and lasts more than 45 minutes after you get up. This can be an inflammatory condition (polymyalgia rheumatica) rather than impingement. If you also get a new headache, pain or tenderness at your temples or on your scalp, or jaw pain when you eat or talk, get medical advice the same day, and if your vision changes, call emergency services. Even without those extra signs, see your doctor within a few days about the aching and stiffness.
- Pain at night or at rest that is constant, that no rest or change of position eases at all, and that keeps getting worse. If you have had cancer, now or in the past, or you have lost weight without trying, get medical advice the same day. This applies even if the pain is not getting worse.
Book an appointment
- Night pain is common with this condition, but get checked within a few days if the pain is constant, no rest or change of position eases it at all, and it keeps getting worse.
Common questions
Why do I have pain from my neck to my shoulder?
A band of pain running from the neck out across the top of the shoulder matches how the neck is described rather than how the shoulder is. The NHS names neck and shoulder pain or stiffness that comes and goes as a symptom of age-related changes in the neck, and an irritated nerve root in the neck commonly brings pain around the shoulder blade with it. Subacromial shoulder pain is described differently: OrthoInfo puts it at the front or side of the shoulder, spreading down the side of the arm rather than up toward the collarbone. None of that settles your own case, and the neck and the shoulder can both be sore at once.
Can shoulder impingement cause elbow pain?
It can ache into the upper arm. OrthoInfo describes the pain radiating from the front of the shoulder to the side of the arm, so an arm that is heavy and sore halfway down fits what is described. What those descriptions do not do is carry the pain past the elbow into the forearm, the hand or the fingers. Pain that travels below the elbow, and anything numb, tingling or weak, is worth having examined rather than put down to the shoulder.
Why does my shoulder hurt near my neck?
Three different things sit in that small area, and they need different plans. The joint where your collarbone meets the shoulder has its own problems and its own page. The muscles that run from the neck to the shoulder blade get sore in their own right, which is common in people whose shoulder has stopped lifting properly. And the neck itself refers pain out across that spot. Where exactly your pain has its center, and what makes it change, is the most useful thing you can bring to an assessment.
Can you have shoulder impingement and a neck problem at the same time?
Yes. Nothing about either one rules out the other, and the pairing explains a familiar story: someone follows a program written for one of the two properly for weeks and gets about half the result they hoped for, because half the pain was never going to answer to it. The Dutch guideline working group ran into the same difficulty from the other end, recording that in the literature they reviewed the difference between subacromial complaints and general pain in the shoulder or neck was not always clear (Diercks and colleagues, 2014).
Which should I treat first, the neck or the shoulder?
That is a question for an assessment rather than a web page, because the answer depends on which one is driving your symptoms today. What you can do is make the choice easier: say at the appointment that both areas are sore, rather than naming the one that hurts most and letting the other go unmentioned. In the meantime, the shoulder blade and upper back work sits in both of our programs, so it is rarely the wrong place to start. One exception comes first: if your neck pain is new and does not feel like your ordinary neck pain, leave the neck exercises and any hands-on treatment to your neck until it has been checked, for the reasons the warning signs on this page set out.
References
- NHS. Shoulder pain. https://www.nhs.uk/symptoms/shoulder-pain/
- NHS. Cervical spondylosis. https://www.nhs.uk/conditions/cervical-spondylosis/
- NHS. Symptoms of a stroke. https://www.nhs.uk/conditions/stroke/symptoms/
- NHS. Meningitis. https://www.nhs.uk/conditions/meningitis/
- Doukhi D, Debette S, Mawet J. Headaches attributed to cranial and cervical artery dissections. The Journal of Headache and Pain. 2025;26(1):28. https://doi.org/10.1186/s10194-025-01958-9
- National Institute for Health and Care Excellence. Spinal metastases and metastatic spinal cord compression (NG234). Published September 2023. https://www.nice.org.uk/guidance/ng234
- American Academy of Orthopaedic Surgeons. Shoulder impingement/rotator cuff tendinitis. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/shoulder-impingementrotator-cuff-tendinitis/
- Diercks R, Bron C, Dorrestijn O, et al. Guideline for diagnosis and treatment of subacromial pain syndrome: a multidisciplinary review by the Dutch Orthopaedic Association. Acta Orthopaedica. 2014;85(3):314-322. https://doi.org/10.3109/17453674.2014.920991
- Kulkarni R, Gibson J, Brownson P, Thomas M, Rangan A, Carr AJ, Rees JL. Subacromial shoulder pain. BESS/BOA Patient Care Pathways. Shoulder and Elbow. 2015;7(2):135-143. https://doi.org/10.1177/1758573215576456
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-18.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.