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5 Possible Causes of Neck and Shoulder Pain


man holding neck while sitting at desk

A pain-free neck, shoulder, and back is like your youth—you don’t truly appreciate it until it’s gone.

“People tend to take it for granted to have a pain-free neck and back until something happens,” said Harvey E. Smith, MD, an orthopaedic spine surgeon at Penn Medicine.

Dr. Smith explains why five everyday actions can especially lead to the kind of debilitating neck, shoulder, and back pain that makes you wonder why you haven’t thanked your lucky stars for not living like this.


Yes, a good night’s sleep can benefit your mental and physical health. But if you sleep “wrong,” it can literally be a pain in neck. And not just any kind of pain, but the kind that makes you afraid to move.

When the muscles around the neck become irritated because of how you slept, they can start to rebel and make it hard for you to turn your head from side to side.

This is known as torticollis. “Muscle irritation can happen from an asymmetrical loading of the neck,” Dr. Smith explained.

“For instance, I’ve had some patients who fell asleep on the couch on their side, while their head was on the armrest,” he added. “The neck was torqued up to an angle much more than would be normal to them.”

Dr. Smith noted this muscle stiffness might be painful, but it’s not dangerous. “They’re not going to hurt themselves by trying to move the neck.”

A couple of days of rest and gentle neck exercises should help. But if not, you can also ask your doctor about physical therapy for stretching exercises.

And to prevent this type of injury from happening again, Dr. Smith recommended supportive sleep postures. “It’s better if you sleep on your back or your stomach with your head on a well-formed, good supportive pillow.”

Doing Housework

Take a typical spring break activity, such as cleaning the gutters on your roof.

“Working overhead, you’re also constantly leaning your head backwards for a long period of time. People who are professionals at this stuff, they do this work all day in certain positions, and they have acclimated themselves to this,” Dr. Smith explained.

“But just like I couldn’t jump off the couch and go run a marathon, if you’ve been sedentary for the winter, you couldn’t go out and work on a ladder for 6 hours cleaning the gutters,” he added. “It’s just not feasible without some type of irritation to your neck and shoulders.”

Dr. Smith recommended taking a break to change positions, and stretching or rotating your neck and shoulders instead of staying in the same position the whole time.

Playing With Kids

Chances are, if you have a kid, you haven’t always been kind to your back and neck.

“I have four kids, and when I go to lift them, one of the things they love to do is jump off the ground into my arms,” Dr. Smith explained. “So first, I was lifting one slowly. The next thing you know, I have an airborne 40-lb projectile object coming at me,” Dr. Smith laughed. “That’s the perfect setup for an injury.”

The better way to play: Bend your knees and lift them as close as you can to your body.

neck and shoulder pain

Slumping Over At Work

“We basically spend most of our time hunched over instead of sitting upright, and that puts more of a load on your back and your neck’s muscles.”

Here’s the irony. “We take the time to set up our homes, so that the TV we watch for hours at a time is at eye level,” Dr. Smith said. “Yet, we’ll work 8 hours a day in our office and not take the time to place our computers on eye level.”

He has even seen companies spend hundreds on fancy ergonomic chairs—but the employees are still slumping over.

The key is to try to take standing or walking breaks from your computer. “And put your computer monitors at a higher elevation,” Dr. Smith said.

Carrying A Shoulder Bag

That big bag you carry to work—loaded with stuff, stuff, and more stuff—might be fashionable. But it might not be doing your shoulders any favors.

“We all compensate to keep our head level with the horizon, so we have our balance,” Dr. Smith explained.

“As the shoulder bag is pulling you down on one side, we’re constantly using the muscles in our backs and necks to keep our head and shoulders upright,” he said. “Throughout the day, you’re constantly straining those muscles.”

That can lead to wear and tear—and pain.

Switching from a shoulder bag to a back pack is also recommended. “They balance the weight across your back,” Dr. Smith said.

If backpacks aren’t your style, the next best thing is to minimize the weight of your bag, shift which shoulder you carry it on, and try to put it down whenever possible.

Overall, the best way to prevent any type of neck, back, or shoulder pain is to just be cognizant of the asymmetrical loading on your spine. “If you’re carrying a heavy weight on one side or you have an extreme posture, do what you can to minimize those situations,” he advised.

“Stretch. Exercise. And maintain a level of basic fitness,” he added. “That can go a long way.”

About this Blog

Get pain management and fitness tips from our orthopaedic doctors, stay up-to-date on the latest advancements in the orthopaedics field, and hear from patients like you, who achieved what once seemed impossible. 

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