The neck, shoulder and arm form a complex system, taking a massive amount of coordinated nervous system control. Many arm problems (eg repetitive strains, tennis elbow) are predisposed by shoulder stiffness, and much arm pain originates in the neck (trapped or irritated nerve effect).
Shoulder pain affects neck function, and because all the nerves that operate the shoulder and arm originate in the neck, then neck problems can cause arm and hand pain. It’s clear, therefore, that all problems in any of these areas necessitate an assessment of all three components, together with their nerve supply.
The shoulder ball and socket joint (in fact, there’s virtually no socket at all) is unusual in that it is the only joint in the body that does not depend on tough inelastic ligaments for stability. Because virtually 360 degrees of mobility are possible, the integrity of this joint depends instead upon a coordinated and balanced system of ‘cuff’ muscles. Most shoulder problems therefore involve poor function or damage to these muscles and their tendons. (In fact, shoulder movement comprises three other joints, all moving synchronously – we hope!)
The so-called ‘frozen shoulder’ is still very poorly understood, and is the rheumatologist’s nightmare. There are no well-researched cures. There is always an extraordinary amount of bracing or gripping of the ‘cuff’ muscle system in the frozen shoulder, which has led to speculations concerning an emotional component; it turns out that frozen shoulders are most common in ‘type A’ personalities, and the late professor Andreason, one of the pioneers of holistic general practice, always considered that people with frozen shoulders had ‘witheld’ rage……
The development of neck pain is very commonly a result of the combined effects of lack of regular movement, degenerative changes and muscle tension caused by stress. Do you use mirrors to reverse the car or turn your neck and torso? Good neck movement is almost redundant in modern life – unless you are a sportsman. As soon as the neck starts to become stiff due to underuse, the likelihood that shoulder dysfunction and arm pain will develop increases dramatically.